Healthcare Provider Details

I. General information

NPI: 1801787171
Provider Name (Legal Business Name): SANTIAM MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 N 1ST AVE
STAYTON OR
97383-1203
US

IV. Provider business mailing address

1401 N 10TH AVE
STAYTON OR
97383-1311
US

V. Phone/Fax

Practice location:
  • Phone: 503-769-9254
  • Fax:
Mailing address:
  • Phone: 503-769-2175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LYNDA FRASER
Title or Position: PAYOR RELATIONS MANAGER
Credential:
Phone: 503-769-9254