Provider Demographics
NPI:1679686463
Name:SILVERTON HEALTH
Entity Type:Organization
Organization Name:SILVERTON HEALTH
Other - Org Name:LEGACY WOODBURN HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-415-5730
Mailing Address - Street 1:PO BOX 3417
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3417
Mailing Address - Country:US
Mailing Address - Phone:503-873-1500
Mailing Address - Fax:503-873-1534
Practice Address - Street 1:1475 MT. HOOD AVE
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071
Practice Address - Country:US
Practice Address - Phone:503-982-2174
Practice Address - Fax:503-982-4599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVERTON HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-16
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213081Medicaid
ORR0000WFBRZOtherMEDICARE- PART B
OR388500Medicare Oscar/Certification