Mid-Columbia Medical Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MID-COLUMBIA MEDICAL CENTER

Doing business as

Adventist Health Columbia Gorge
MCMC Specialties Goldendale

Practice address

317 Sanders Way
Goldendale, WA 98620-9059

Phone

(541) 296-1111

NPI assigned

Nov 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kyle King

Title

Service Area President

Phone

(503) 261-4405

Specialties & licenses 1

Addresses

Other names 2

• Adventist Health Columbia Gorge Doing business as
• MCMC Specialties Goldendale Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1679086516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588003",
            "telephone_number": "541-506-6530",
            "fax_number": "541-506-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 SANDERS WAY",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "986209059",
            "telephone_number": "541-296-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COLUMBIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "SERVICE AREA PRESIDENT",
        "authorized_official_telephone_number": "503-261-4405"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Columbia Gorge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMC Specialties Goldendale",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMC Specialties Goldendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra Mannino, RN
• Sara R Marvin, LMP
• Mohammad Masudian, DDS, MPH
• Mellissa Tang McBean, NA-C
• Chelsey McIntyre, PHARMD
• Dorothy Miller
• Mobile Home Specialist
• Michelle Christine Morgan
• Mona Morgan
• Ashley Lynn Murphy, LMT

• Multi-Specialty Clinic/Center in Goldendale, WA
• Providers in Goldendale, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.