Healthcare Provider Details

I. General information

NPI: 1063758316
Provider Name (Legal Business Name): SMARITAN HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 NW 9TH ST SUITE 310
CORVALLIS OR
97330-6169
US

IV. Provider business mailing address

777 NW 9TH ST SUITE 310
CORVALLIS OR
97330-6169
US

V. Phone/Fax

Practice location:
  • Phone: 541-768-5850
  • Fax: 541-768-5851
Mailing address:
  • Phone: 541-768-5850
  • Fax: 541-768-5851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BECKY A PAPE
Title or Position: COO
Credential:
Phone: 541-768-5009