Healthcare Provider Details

I. General information

NPI: 1215274360
Provider Name (Legal Business Name): SILVERTON HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 WELCH ST
SILVERTON OR
97381
US

IV. Provider business mailing address

PO BOX 4037
PORTLAND OR
97208
US

V. Phone/Fax

Practice location:
  • Phone: 503-873-8853
  • Fax: 503-873-8355
Mailing address:
  • Phone: 503-873-1500
  • Fax: 503-873-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

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