Siskiyou Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

127725 Issued in OR

Legal business name

SISKIYOU COMMUNITY HEALTH CENTER, INC.

Practice address

25647 Redwood Hwy
Cave Junction, OR 97523-9332

Phone

(541) 592-4111

Fax

(541) 592-3916

NPI assigned

Jul 31, 2008

Last updated

Jun 30, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

SISKIYOU COMMUNITY HEALTH CENTER INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Van Houten, MSW, MBA

Title

Ceo

Phone

(541) 472-4777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669638417. Details of each certification follow.

• CCN 381865 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 381865

Legal name

SISKIYOU COMMUNITY HEALTH CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 3, 2004

Last certification

May 3, 2004

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

May 1, 1975 in OR

Enrollment address

25647 Redwood Hwy
Cave Junction, OR 97523-9332

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Siskiyou Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
  • NPI 1427046903

  6305747288

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Siskiyou Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
  • NPI 1427046903

  O20040114000536

  Same enrollment

Part of

James D Nordal

Locations

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin White Allison, MD

  • Family Medicine Physician
  • Cave Junction, OR
  • NPI 1306409305
  NPD
• Mary Lou Alonso, NP1578815783

  • Adult Health Nurse Practitioner
  • Cave Junction, OR
  • NPI 1578815783
  NPD
• Laura Anderson, DNP APRN-NP

  • Nurse Practitioner
  • Grants Pass, OR
  • NPI 1093110306
  NPD
• Christopher Robert Cielinski

  • Medical Physician Assistant
  • Grants Pass, OR
  • NPI 1619428208
  NPD
• Glendon E Cook, M.D.

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1952343816
  NPD
• Tiffany M Crane, NP

  • Nurse Practitioner
  • Cave Junction, OR
  • NPI 1326586181
  NPD
• Meg Irene Dotson, MD

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1407598220
  NPD
• Stanton Ulysses Dotson, DDS

  • General Practice Dentistry
  • Grants Pass, OR
  • NPI 1962071662
  NPD
• Mischa Lorraine Fiske, FNP

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1609571181
  NPD
• Keaton James Fletcher, DO

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1053042408
  NPD
• M Crystal Hill, M.D.

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1396797759
  NPD
• Christian Stewart Holland, D.O.

  • Internal Medicine Physician
  • Grants Pass, OR
  • NPI 1205045564
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1669638417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261051",
            "telephone_number": "541-472-4777",
            "fax_number": "541-471-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25647 REDWOOD HWY",
            "city": "CAVE JUNCTION",
            "state": "OR",
            "postal_code": "975239332",
            "telephone_number": "541-592-4111",
            "fax_number": "541-592-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISKIYOU COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2008-07-31",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "VAN HOUTEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-472-4777",
        "authorized_official_credential": "MSW, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OR",
            "license": "127725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Gabriele Semper, LMT
• Siskiyou Community Health Center Inc
• Siskiyou Community Health Center Pharmacy
• Siskiyou Community Health Center Pharmacy
• Siskiyou Community Health Center, Inc.
• Siskiyou Community Health Center, Inc.
• Siskiyou Community Health Center, Inc.
• Jeffrey Allan Staab, LMT
• Mona Gitte Ritter Staehr, QMHA
• William Douglas Steinman, MD

• Federally Qualified Health Center (FQHC) in Cave Junction, OR
• Providers in Cave Junction, OR by specialty
• Federally Qualified Health Center (FQHC) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.