# PROVIDENCE SILVERTON REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE SILVERTON REHAB LLC
- **Other names:** WELLSPRING PHYSICAL REHABILITATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619172780
- **Legal business name:** PROVIDENCE SILVERTON REHAB LLC
- **Authorized official:** DANA L MONTGOMERY (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (503) 893-7295

## Contact information

- **Practice address:** 1475 MT. HOOD AVE, WOODBURN, OR 97071-9066
- **Practice address phone:** (971) 983-5206
- **Practice address fax:** (971) 983-5211
- **Mailing address:** PO BOX 3290, PORTLAND, OR 97208-3290
- **Mailing address phone:** (503) 215-4323
- **Mailing address fax:** (503) 215-0297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/19/2007
- **Last updated:** 10/01/2012