# GOOD SAMARITAN HOSPITAL CORVALLIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Samaritan Medical Group Family Medicine - 26th Street
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184317356
- **Authorized official:** LAURA HENNUM (CEO - GSRMC)
- **Authorized official phone:** (541) 768-5011

## Contact information

- **Practice address:** 850 SW 26TH ST, CORVALLIS, OR 97330-5427
- **Practice address phone:** (541) 768-8800
- **Practice address fax:** (541) 359-4070
- **Mailing address:** PO BOX 1189, CORVALLIS, OR 97339-1189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2023
- **Last updated:** 06/01/2023