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Organization

OREGON DEPT. OF CORRECTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN R. SHELTON MD (MEDICAL DIRECTOR)
(503) 378-5530
Entity
Organization

Contact information

Practice address
2757 22ND ST SE, SALEM, OR 97302-1553
(503) 378-5507
Mailing address
2757 22ND ST SE, SALEM, OR 97302-1553
(503) 378-5507

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
80045964
OR

Other

Enumeration date
03/11/2016
Last updated
03/11/2016
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