Healthcare Provider Details
I. General information
NPI: 1508294513
Provider Name (Legal Business Name): SILVERTON HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2013
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5685 INLAND SHORES WAY N
KEIZER OR
97303
US
IV. Provider business mailing address
PO BOX 4037
PORTLAND OR
97208
US
V. Phone/Fax
- Phone: 503-779-2271
- Fax: 503-779-2272
- Phone: 503-873-1500
- Fax: 503-873-1534
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
HOFF
Title or Position: CFO
Credential:
Phone: 503-415-5730