Provider Demographics
NPI:1922453943
Name:PROVIDENCE HEALTH & SERVICES OREGON
Entity Type:Organization
Organization Name:PROVIDENCE HEALTH & SERVICES OREGON
Other - Org Name:PROV HOOD RIVER MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REIMBURSEMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MOUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-687-3910
Mailing Address - Street 1:1550 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-8553
Mailing Address - Country:US
Mailing Address - Phone:541-387-6370
Mailing Address - Fax:
Practice Address - Street 1:1550 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-8553
Practice Address - Country:US
Practice Address - Phone:541-387-6370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility