Healthcare Provider Details

I. General information

NPI: 1306191044
Provider Name (Legal Business Name): SILVERTON HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 FAIRVIEW ST
SILVERTON OR
97381
US

IV. Provider business mailing address

PO BOX 4037
PORTLAND OR
97208
US

V. Phone/Fax

Practice location:
  • Phone: 503-873-5667
  • Fax: 503-873-5687
Mailing address:
  • Phone: 503-873-1500
  • Fax: 503-873-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA HOFF
Title or Position: CFO
Credential:
Phone: 503-415-5730