Provider Demographics
NPI:1942454087
Name:WILLAMETTE FALLS HOSPITAL
Entity Type:Organization
Organization Name:WILLAMETTE FALLS HOSPITAL
Other - Org Name:WILLAMETTE FALLS SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-723-6525
Mailing Address - Street 1:1510 DIVISION ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1581
Mailing Address - Country:US
Mailing Address - Phone:503-723-6525
Mailing Address - Fax:503-723-6508
Practice Address - Street 1:1510 DIVISION ST
Practice Address - Street 2:SUITE 170
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1581
Practice Address - Country:US
Practice Address - Phone:503-650-6288
Practice Address - Fax:503-650-6884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD276192081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty