Healthcare Provider Details

I. General information

NPI: 1285667188
Provider Name (Legal Business Name): JOSEPH PATRICK SANTIAGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WARM SPRINGS HEALTH AND WELLNESS CENTER 1270 KOT-NUM ROAD
WARM SPRINGS OR
97761
US

IV. Provider business mailing address

PO BOX 1209
WARM SPRINGS OR
97761-1209
US

V. Phone/Fax

Practice location:
  • Phone: 541-553-1196
  • Fax: 541-553-2135
Mailing address:
  • Phone: 541-553-1196
  • Fax: 541-553-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK9654
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: