Provider Demographics
NPI:1548443476
Name:WILLAMETTE UNIVERSITY
Entity type:Organization
Organization Name:WILLAMETTE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BISHOP WELLNESS CENTER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-370-6062
Mailing Address - Street 1:900 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3922
Mailing Address - Country:US
Mailing Address - Phone:503-370-6062
Mailing Address - Fax:503-375-5420
Practice Address - Street 1:900 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3922
Practice Address - Country:US
Practice Address - Phone:503-370-6062
Practice Address - Fax:503-375-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health