SANTIAM MEMORIAL HOSPITAL (NPI# 1023628419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023628419 |
| Entity Type | Organization |
| Organization Name | SANTIAM MEMORIAL HOSPITAL |
| Practice Address |
5000 Deer Park Dr Se Salem OR 97317-9392 |
| Mailing Address |
1401 N 10th Ave Stayton OR 97383-1311 |
| Practice Telephone | 5035898101 |
| Mailing Telephone | 5037699254 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | LYNDA FRASER (CLINIC DIRECTOR) |
| Authorized Official Telephone | 5037699254 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Corban University Student Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205048097 | Santiam Memorial Hospital | Family Medicine | 280 S First Ave, Mill City, OR 97360 | 2007-05-04 |
| 1154302214 | Santiam Memorial Hospital | General Acute Care Hospital | 1401 N 10th Ave, Stayton, OR 97383-1485 | 2005-11-07 |
| 1154814390 | Santiam Memorial Hospital | Clinic/Center | 1371 N 10th Ave, Stayton, OR 97383 | 2018-06-12 |
| 1912413147 | Santiam Memorial Hospital | Clinic/Center | 1369 N 10th Ave, Stayton, OR 97383 | 2017-12-26 |
| 1275049850 | Santiam Memorial Hospital | Clinic/Center | 1401 N 10th Ave Ste 200, Stayton, OR 97383 | 2017-12-19 |
| 1982154712 | Santiam Memorial Hospital | General Acute Care Hospital | 1401 N 10th Ave, Stayton, OR 97383-1311 | 2016-10-05 |
| 1477909570 | Santiam Memorial Hospital | Clinic/Center | 1401 N 10th Ave, Ste. 100, Stayton, OR 97383-1486 | 2016-05-06 |
| 1518354547 | Santiam Memorial Hospital | Clinic/Center | 114 Se Church St, Sublimity, OR 97385-9714 | 2015-04-16 |
| 1790171874 | Santiam Memorial Hospital | Clinic/Center | 1375 N 10th Ave, Suite B, Stayton, OR 97383-2099 | 2015-04-15 |
| 1396131389 | Santiam Memorial Hospital | Clinic/Center | 280 S 1st Ave, Mill City, OR 97360-0003 | 2015-04-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SANTIAM MEMORIAL HOSPITAL | 1401 N 10th Ave, Stayton, OR 97383 |
| System for Award Management (SAM) Entities | SANTIAM MEMORIAL HOSPITAL | 1401 N 10th Ave, Stayton, OR 97383-1311 |
| Street Address |
5000 DEER PARK DR SE |
| City | SALEM |
| State | OR |
| Zip Code | 97317-9392 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730285859 | Jennifer D Garrard | Specialist/Technologist | 5000 Deer Park Dr Se, Salem, OR 97317-9392 | 2006-09-16 |
| 1841410057 | Jennifer Krug | Specialist/Technologist | 5000 Deer Park Dr Se, Salem, OR 97317 | 2007-04-27 |
| 1831319300 | Anthony Lee Walther | Specialist/Technologist | 5000 Deer Park Dr Se, Salem, OR 97301-9330 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962932996 | Corinna Leona Zib | Counselor | 4726 Appaloosa Ct Se, Salem, OR 97317 | 2017-06-13 |
| 1639537889 | Nikole Stormo | Massage Therapist | 4675 Campbell Dr Se Apt267, Salem, OR 97317 | 2016-02-03 |
| 1174698971 | Christian Community Placement Center | Foster Care Agency | 4890 32nd Ave Se, Salem, OR 97317 | 2006-11-21 |
| 1235653569 | Alexis Panther | Community Health Worker | 4890 32nd Ave Se, Salem, OR 97317 | 2017-07-28 |
| 1114479128 | Jocelyn Gran | Pharmacist | 2400 Lancaster Dr Ne, Salem, OR 97317 | 2016-10-26 |
| 1649498262 | Carol Adams | Social Worker | 1164 63rd Ave Ne, Salem, OR 97317-2313 | 2007-04-20 |
| 1992114490 | Pathways - Child and Family Services - LLC | Community/Behavioral Health | 1164 63rd Ave Ne, Salem, OR 97317-2313 | 2014-08-08 |
| 1417513235 | James Matthew Conway | Social Worker | 5100 Center St Ne, Salem, OR 97317-3217 | 2019-05-16 |
| 1043876865 | Home Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5100 Center St Ne, Salem, OR 97317-3217 | 2019-05-16 |
| 1689086530 | Ruben Chekhov | Dental Hygienist | 4932 Turquoise Ave Se, Salem, OR 97317-4109 | 2014-05-27 |
| Find all providers in zip 97317 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255671558 | Salem State University | Clinic/Center | 352 Lafayette St, Counseling and Health Services, Salem, MA 01970-5348 | 2013-02-22 |
| 1548443476 | Willamette University | Clinic/Center | 900 State St, Salem, OR 97301-3922 | 2007-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609334572 | Angel Dolores Rodriguez | Clinic/Center | 821 Century Dr Ne Apt 302, Albany, OR 97322-4582 | 2019-03-08 |
| 1962966184 | Klamath Health Partnership, Inc | Clinic/Center | 3013 Summers Lane, Klamath Falls, OR 97601-9760 | 2019-01-23 |
| 1700247491 | Lane Education Service District | Clinic/Center | 1200 Highway 99 N, Eugene, OR 97402-2014 | 2016-03-09 |
| 1801254644 | Oregon Health & Science University | Clinic/Center | 546 Ne 12th Ave, Room 126, Portland, OR 97232-2719 | 2016-02-08 |
| 1982081535 | One Community Health | Clinic/Center | 1220 Indian Creek Drive, Hood River, OR 97031-8632 | 2015-05-04 |
| 1629332333 | Verdura Family Wellness, Inc | Clinic/Center | 120 Larch Pl, Yamhill, OR 97148-2007 | 2012-06-27 |
| 1396071734 | Lincoln County Health and Human Services | Clinic/Center | 3780 Se Spy Glass Ridge Dr, Lincoln City, OR 97367-1939 | 2009-10-20 |
| 1710153044 | Coacheslibrary | Clinic/Center | 14103 Sw Wagoner Pl, Tigard, OR 97224-1796 | 2008-05-06 |
| 1336323252 | George Fox University | Clinic/Center | 414 N Meridian St # 6128, Newberg, OR 97132-2697 | 2007-12-27 |
| 1215072228 | Portland State University Center for Student Health and Counseling | Clinic/Center | 1880 Sw 6th Ave, Suite 200, Portland, OR 97201-5204 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.