Provider Demographics
NPI:1710241922
Name:SILVERTON HOSPITAL
Entity Type:Organization
Organization Name:SILVERTON HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FISK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-769-4275
Mailing Address - Street 1:700 SW LUPINE CT
Mailing Address - Street 2:
Mailing Address - City:SUBLIMITY
Mailing Address - State:OR
Mailing Address - Zip Code:97385-9509
Mailing Address - Country:US
Mailing Address - Phone:503-769-4275
Mailing Address - Fax:
Practice Address - Street 1:700 SW LUPINE CT
Practice Address - Street 2:
Practice Address - City:SUBLIMITY
Practice Address - State:OR
Practice Address - Zip Code:97385-9509
Practice Address - Country:US
Practice Address - Phone:503-769-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR097000661RN282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital