Organization
SANTIAM MEMORIAL HOSPITAL ER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY FLETCHALL (CHIEF EXECUTIVE OFFICER)
(503) 769-9233
Entity
Organization
Contact information
Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-2175
(503) 769-5312
Mailing address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-2175
(503) 769-5312
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0555102-0
OR
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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