DR. PHIL WASHBURN (NPI# 1558430470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558430470 |
| Entity Type | Individual |
| Full Name | DR. PHIL WASHBURN |
| Credential | MD |
| Practice Address |
251 W Hwy 198 Salem UT 84653-0786 |
| Mailing Address |
Box 786 Salem UT 84653-0786 |
| Practice Telephone | 8014233267 |
| Practice Fax Number | 8014233276 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
1460518905 | UT | Allopathic & Osteopathic Physicians |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BW9848752 | 01 |
| Street Address |
251 W HWY 198 |
| City | SALEM |
| State | UT |
| Zip Code | 84653-0786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1811357791 | Melanie Pace | Dental Hygienist | 818 East 750 South, Salem, UT 84653 | 2016-03-04 |
| 1265773899 | Bill Clifford Marshall | Marriage & Family Therapist | 405 S Maple Dr, Woodland Hills, UT 84653 | 2013-03-06 |
| 1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
| 1780884247 | David Kent Hansen | Dentist | 204 East 400 North, Suite A, Salem, UT 84653 | 2007-07-23 |
| 1154524965 | Justin Thomas Perry | Dentist | 40 South 200 West, Salem, UT 84653 | 2007-06-08 |
| 1013130947 | John E Braithwaite | Dentist | 40 S 200 W, Salem, UT 84653 | 2007-04-10 |
| 1104972827 | Salem City Corporation | Ambulance | 30 W 100 S, Salem, UT 84653 | 2007-01-26 |
| 1700989209 | James Bryan Bonny | Dentist | 245 W State Hwy 198, Suite 6, Salem, UT 84653 | 2006-09-07 |
| 1578574570 | Kids Who Count | Day Training, Developmentally Disabled Services | 345 N Sr 198, Salem, UT 84653 | 2006-08-11 |
| Find all providers in zip 84653 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215142294 | Donald Dravis | Psychiatry & Neurology | Oregon State Penitentiary, 2605 State Street, Salem, OR 97310-0001 | 2007-05-11 |
| 1780788901 | Alexander Earle Horwitz IIi | Psychiatry & Neurology | 265 Commercial St Se, Ste 280, Salem, OR 97301-3461 | 2006-09-08 |
| 1316972524 | Gilberto De Jesus-rentas | Psychiatry & Neurology | 2755 Commercial St Se, #101-315, Salem, OR 97302-4981 | 2006-07-12 |
| 1356634778 | Kavya Singareddy | Psychiatry & Neurology | 81 Highland Ave, Department of Psychiatry, Salem, MA 01970-2714 | 2011-05-18 |
| 1528371101 | Tushar J Makadia | Psychiatry & Neurology | 2600 Center St Ne, Salem, OR 97301-2669 | 2010-07-23 |
| 1629251301 | Michael P Duran | Psychiatry & Neurology | 2600 Center St Ne, Oregon State Hospital Salem, Salem, OR 97301 | 2007-12-17 |
| 1679677801 | Scott Mitchell Reichlin | Psychiatry & Neurology | 2600 Center St Ne, Salem, OR 97301 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558332353 | David L Moulton | Psychiatry & Neurology | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2006-01-30 |
| 1548244676 | Poonam Soni | Psychiatry & Neurology | 3970 S 700 E Ste 12, Salt Lake City, UT 84107-2584 | 2005-12-01 |
| 1750989349 | Wellcon, Inc. | Psychiatry & Neurology | 3415 S 900 W, South Salt Lake, UT 84119-4103 | 2020-10-15 |
| 1841310950 | Benjamin Todd Thatcher | Psychiatry & Neurology | 1020 S Main St, #300, Salt Lake City, UT 84101-3176 | 2007-03-30 |
| 1780731679 | Aaron James Hunt | Psychiatry & Neurology | 1300 E Center St, Provo, UT 84606-3554 | 2007-01-04 |
| 1639269269 | David A. Tomb | Psychiatry & Neurology | 50 N Medical Dr, Salt Lake City, UT 84132 | 2006-10-13 |
| 1174546337 | Trent C. Holmberg | Psychiatry & Neurology | 12176 S 1000 E, Suite B, Draper, UT 84020-9734 | 2006-07-26 |
| 1568483030 | Joseph D Dye | Psychiatry & Neurology | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2006-07-21 |
| 1013995471 | Edward Leslie Kelly | Psychiatry & Neurology | 1300 E Center St, Provo, UT 84606-3554 | 2006-01-05 |
Please comment or provide details below to improve the information on DR. PHIL WASHBURN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.