Healthcare Provider Details

I. General information

NPI: 1518980457
Provider Name (Legal Business Name): WILLAMETTE VALLEY MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SE STRATUS AVE
MCMINNVILLE OR
97128-6255
US

IV. Provider business mailing address

2700 SE STRATUS AVE
MCMINNVILLE OR
97128-6255
US

V. Phone/Fax

Practice location:
  • Phone: 503-472-6131
  • Fax: 503-472-8691
Mailing address:
  • Phone: 503-472-6131
  • Fax: 503-472-8691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECCA HURLEY
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 214-473-3993