Provider Demographics
NPI:1043543309
Name:WILLAMATTE FALLS HOSPITAL
Entity Type:Organization
Organization Name:WILLAMATTE FALLS HOSPITAL
Other - Org Name:WILLAMETTE FALLS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DAME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-655-7581
Mailing Address - Street 1:1505 DIVISION ST.
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045
Mailing Address - Country:US
Mailing Address - Phone:503-655-7581
Mailing Address - Fax:503-655-7585
Practice Address - Street 1:1505 DIVISION ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1526
Practice Address - Country:US
Practice Address - Phone:503-655-7581
Practice Address - Fax:503-655-7585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLAMETTE FALLS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2252282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital