# SANTIAM MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Santiam Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205048097
- **Authorized official:** SHANNON R WADDLE (OFFICE MANAGER)
- **Authorized official phone:** (503) 897-4100

## Contact information

- **Practice address:** 280 S FIRST AVE, MILL CITY, OR 97360
- **Practice address phone:** (503) 897-4100
- **Practice address fax:** (503) 897-2673
- **Mailing address:** PO BOX 47, MILL CITY, OR 97360-0047
- **Mailing address phone:** (503) 897-4100
- **Mailing address fax:** (503) 897-2673

## Taxonomy

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

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 09/28/2016