Healthcare Provider Details

I. General information

NPI: 1639254204
Provider Name (Legal Business Name): SILVERTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 WEST MAIN STREET
MOLALLA OR
97038
US

IV. Provider business mailing address

452 WELCH ST
SILVERTON OR
97381-1934
US

V. Phone/Fax

Practice location:
  • Phone: 503-873-1722
  • Fax: 503-874-2479
Mailing address:
  • Phone: 503-873-1722
  • Fax: 503-874-2479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY P FRITSCHE
Title or Position: CFO
Credential:
Phone: 503-873-1548