PROVIDENCE SILVERTON REHAB LLC (NPI# 1619172780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619172780 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SILVERTON REHAB LLC |
| Other Organization Name | WELLSPRING PHYSICAL REHABILITATION |
| Practice Address |
1475 Mt. Hood Ave Woodburn OR 97071-9066 |
| Mailing Address |
Po Box 3290 Portland OR 97208-3290 |
| Practice Telephone | 9719835206 |
| Practice Fax Number | 9719835211 |
| Mailing Telephone | 5032154323 |
| Mailing Fax Number | 5032150297 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2012-10-01 |
| Authorized Official Name | DANA L MONTGOMERY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5038937295 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE SILVERTON REHAB LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RAILROAD MEDICARE PART B | DA5512 | 01 |
| Other Name | Type Code |
|---|---|
| WELLSPRING PHYSICAL REHABILITATION | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659444610 | Providence Silverton Rehab LLC | Occupational Therapist | 240 Phelps St, Silverton, OR 97381-1927 | 2006-11-16 |
| Street Address |
1475 MT. HOOD AVE |
| City | WOODBURN |
| State | OR |
| Zip Code | 97071-9066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083663009 | Julie Christine Broyhill | Legal Medicine | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2006-05-08 |
| 1215347109 | Silverton Health | Clinic/Center | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2014-05-01 |
| 1740621861 | Kristen Marie Leinung | Registered Nurse | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2013-07-17 |
| 1114274859 | Audry B Van Houweling | Nurse Practitioner | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2012-08-13 |
| 1114239936 | Jamey Lynn Walker | Emergency Medicine | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2010-07-09 |
| 1518139617 | Stacy M Anderson | Nurse Practitioner | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2008-03-28 |
| 1114124641 | Stephen Joseph Comella | Counselor | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2007-06-28 |
| 1679686463 | Silverton Health | Clinic/Center | 1475 Mt. Hood Ave, Woodburn, OR 97071 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628839 | Carla Frances Halvorson | Technician | 955 Carol St Apt D, Woodburn, OR 97071 | 2019-09-19 |
| 1851801856 | Angela Hill | Massage Therapist | 564 Ray J Glatt Cirle, Woodburn, OR 97071 | 2017-10-04 |
| 1154713295 | Theresa Donavant-butler | Massage Therapist | 564 Glatt Circle, Woodburn, OR 97071 | 2015-02-26 |
| 1710257878 | Darlene Jost-babin | Counselor | 693 Ray J Glatt Circle, Woodburn, OR 97071 | 2012-01-06 |
| 1932401437 | Marcelino Mauro Vera Ramirez | Chiropractor | 844 Pana Street, Woodburn, OR 97071 | 2010-12-03 |
| 1801110994 | Woodburn Cosmetic & Family Dentistry P.C. | Dentist | 1018 N. Boones Ferry Rd., Woodburn, OR 97071 | 2010-03-18 |
| 1568786911 | Woodburn Dental Group, P.C. | Dentist | 1034 N. Boones Ferry Rd., Woodburn, OR 97071 | 2010-03-15 |
| 1134384985 | Roberto Diaz Camarillo | Counselor | 399 Young Street, Woodburn, OR 97071 | 2008-07-22 |
| 1447431705 | Patricia Eddy | Physical Therapist | 1475 Mt Hood Avenue, Woodburn, OR 97071 | 2007-11-15 |
| 1992926471 | Marquis Physical Therapy & Spine Rehab, PC | Physical Therapist | 2241 Country Club Rd, Woodburn, OR 97071 | 2007-05-01 |
| Find all providers in zip 97071 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292639 | Blueprint Sports Therapy | Clinic/Center | 17440 Sw Reusser Ct, Beaverton, OR 97007-8772 | 2020-10-14 |
| 1790383982 | Fluid Movement LLC | Clinic/Center | 2565 Bowmont Dr, Eugene, OR 97405-1407 | 2020-10-11 |
| 1184221335 | Convergence Physical Therapy and Performance | Clinic/Center | 303 S 5th St Ste 140, Springfield, OR 97477-5480 | 2020-10-01 |
| 1356969976 | Readygo Physical Therapy LLC | Clinic/Center | 904 Se 69th Ave, Portland, OR 97215-2120 | 2020-07-09 |
| 1619591815 | Cyti LLC | Clinic/Center | 11350 Sw Canyon Rd # 202, Beaverton, OR 97005-2234 | 2020-06-03 |
| 1144865841 | St. Johns Physical Therapy | Clinic/Center | 8835 N Bradford St, Portland, OR 97203-2869 | 2019-11-18 |
| 1750930004 | Revolutions Physical Therapy LLC | Clinic/Center | 8751 Sw Pamlico Ct, Tualatin, OR 97062-9345 | 2019-09-10 |
| 1487202362 | Mpt LLC | Clinic/Center | 98158 W Benham Ln Ste 10, Brookings, OR 97415-9546 | 2019-09-03 |
| 1215584446 | Patrick Franko Pt LLC | Clinic/Center | 2331 Ne 43rd Ave, Portland, OR 97213-1332 | 2019-08-22 |
| 1689228686 | Ground Work Physical Therapy | Clinic/Center | 2330 Ne Division St Ste 1, Bend, OR 97703-3570 | 2019-07-29 |
| 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.