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SANTIAM MEDICAL CLINIC
NPI 1205048097
Family Medicine in Mill City, OR

Active since May 04, 2007CLIA 38D0712188 · Waiver
280 S FIRST AVE, MILL CITY, OR 97360(503) 897-4100(503) 897-2673 Get Directions Write a Review

NPPES record last updated: September 28, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Santiam Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANTIAM MEDICAL CLINIC (NPI 1205048097) is a healthcare organization registered as a family medicine in Mill City, Oregon and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through November 14, 2027 and lists Shannon R Waddle, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1205048097
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSANTIAM MEMORIAL HOSPITAL
Location Address280 S FIRST AVEMill City, OR 97360
Mailing AddressPo Box 47Mill City, OR 97360-0047 · (503) 897-4100 · Fax (503) 897-2673
Phone(503) 897-4100
Fax(503) 897-2673
Organization SubpartNo
Authorized OfficialShannon R WaddleOffice Manager · (503) 897-4100
Enumeration DateMay 4, 2007
Last NPPES UpdateSeptember 28, 2016
✔ NPI 1205048097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

280 S FIRST AVE, Mill City, OR 97360
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Other Names 1

Doing Business AsSantiam Medical Clinic

Other Identifiers 1

Medicare PINR112475OR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D0712188

Santiam Medical Clinic · Mill City, OR
Active · expires Nov 14, 2027
CLIA Number38D0712188
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2025
Certificate Expiration DateNovember 14, 2027
Laboratory DirectorLynn Gower Do
Laboratory Phone(503) 897-4100
Laboratory LocationSantiam Medical Clinic280 S First Ave, Mill City, OR 97360
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Santiam Memorial Hospital's NPI number?

The NPI number for Santiam Memorial Hospital is 1205048097. It was assigned to this organization in the NPPES registry on May 4, 2007. The provider is doing business as Santiam Medical Clinic.

Where is Santiam Memorial Hospital located?

Santiam Memorial Hospital is located at 280 S First Ave, Mill City, OR 97360. The listed phone number is (503) 897-4100.

What is Santiam Memorial Hospital's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Santiam Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0712188) is associated with this NPI, valid through November 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Santiam Memorial Hospital accept?

Health plans from Providence Health Plan list Santiam Memorial Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Santiam Memorial Hospital was last updated on September 28, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.