Healthcare Provider Details

I. General information

NPI: 1013450287
Provider Name (Legal Business Name): COMMONSPIRIT OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 NW STEWART PKWY
ROSEBURG OR
97471-1281
US

IV. Provider business mailing address

2801 NW MERCY DR STE 340
ROSEBURG OR
97471-2348
US

V. Phone/Fax

Practice location:
  • Phone: 541-677-4319
  • Fax: 541-677-2294
Mailing address:
  • Phone: 541-677-4319
  • Fax: 541-677-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMIE C POINDEXTER
Title or Position: MARKET VP OPERATIONAL FINANCE
Credential:
Phone: 541-677-2458