=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619896073
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOOD SAMARITAN HOSPITAL CORVALLIS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2026
-----------------------------------------------------
Last Update Date | 07/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 990 NW CIRCLE BLVD STE 101
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97330-1967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-768-8020
-----------------------------------------------------
Fax | 541-255-3180
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1189
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97339-1189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-768-4410
-----------------------------------------------------
Fax | 541-768-4613
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO-GSRMC
-----------------------------------------------------
Name | JOSIAH JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 541-768-5009
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------