Provider Demographics
NPI:1700056694
Name:MARION COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MARION COUNTY HEALTH DEPARTMENT
Other - Org Name:MARION COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH AIDE
Authorized Official - Prefix:MS
Authorized Official - First Name:PHATANY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHHEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-588-5355
Mailing Address - Street 1:747 HORSEBACK CT NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3195
Mailing Address - Country:US
Mailing Address - Phone:503-581-4597
Mailing Address - Fax:
Practice Address - Street 1:747 HORSEBACK CT NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3195
Practice Address - Country:US
Practice Address - Phone:503-581-4597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical