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Organization
PEACEHEALTH
Active
Organization
PEACEHEALTH
Active
Other names
Sacred Heart Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HODGKINSON (EVP/CFO)
(360) 729-1102
Entity
Organization
Contact information
Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8803
(541) 335-2700
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
OR
207RC0000X
Cardiovascular Disease Physician
—
OR
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
OR
207RI0011X
Interventional Cardiology Physician
—
OR
208600000X
Surgery Physician
—
OR
2086S0120X
Pediatric Surgery Physician
—
OR
208M00000X
Hospitalist Physician
Primary
—
OR
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
OR
363AM0700X
Medical Physician Assistant
—
OR
363AS0400X
Surgical Physician Assistant
—
OR
363L00000X
Nurse Practitioner
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022910
—
OR
Enumeration date
06/14/2006
Last updated
04/07/2017
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