Healthcare Provider Details

I. General information

NPI: 1942357355
Provider Name (Legal Business Name): SAMARITAN PACIFIC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 N HIGHWAY 101 STE A
DEPOE BAY OR
97341-9572
US

IV. Provider business mailing address

531 N HIGHWAY 101 STE A
DEPOE BAY OR
97341-9572
US

V. Phone/Fax

Practice location:
  • Phone: 541-765-3265
  • Fax: 541-765-3260
Mailing address:
  • Phone: 541-765-3265
  • Fax: 541-765-3260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LESLEY OGDEN
Title or Position: CEO
Credential:
Phone: 541-557-6411