Provider Demographics
NPI:1477670172
Name:COLUMBIA PAIN MANAGEMENT, INC.
Entity Type:Organization
Organization Name:COLUMBIA PAIN MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIGERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-386-9500
Mailing Address - Street 1:2149 W CASCADE, #106A
Mailing Address - Street 2:PMB 232
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-386-9500
Mailing Address - Fax:541-386-9540
Practice Address - Street 1:1010 TENTH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-386-9500
Practice Address - Fax:541-386-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22786208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287822Medicaid
ORF11879Medicare UPIN
OR287822Medicaid