PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1689845489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689845489 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROV PEDS NEUROLOGY SALEM |
| Practice Address |
2478 13th St Se Salem OR 97302-2522 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5033622481 |
| Mailing Telephone | 5032156494 |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2014-12-24 |
| Authorized Official Name | KEENAN B FREEMAN (CFO) |
| Authorized Official Telephone | 5038936524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 279131 | 05 |
| Other Name | Type Code |
|---|---|
| PROV PEDS NEUROLOGY SALEM | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
| 1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
| 1114085545 | Providence Health & Services - Oregon | Internal Medicine | 1314 E Sherman St, Newberg, OR 97132-1842 | 2006-12-05 |
| 1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
| 1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
| 1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
| 1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
2478 13TH ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801889308 | Karin D Weiler | Pediatrics | 2478 13th St Se, Salem, OR 97302-2546 | 2005-08-30 |
| 1346727450 | Michelle P Pavelek | Occupational Therapist | 2478 13th St Se, Salem, OR 97302 | 2018-07-20 |
| 1265941462 | Kimberly Rachel Bowen | Speech-Language Pathologist | 2478 13th St Se, Salem, OR 97302-2522 | 2017-09-20 |
| 1841654522 | Amanda Jane Cotey | Pediatrics | 2478 13th St Se, Salem, OR 97302-2522 | 2016-04-08 |
| 1750749990 | Lucinda Jane Hudson | Occupational Therapist | 2478 13th St Se, Salem, OR 97302-2522 | 2016-02-02 |
| 1063773752 | Rachael Hiebert | Pediatrics | 2478 13th St Se, Salem, OR 97302-2546 | 2012-05-30 |
| 1538459938 | Wvp Medical Group, LLC | Clinic/Center | 2478 13th St Se, Ste. 200, Salem, OR 97302-2546 | 2011-04-19 |
| 1649506437 | Chelsea Zeal Roberts | Physician Assistant | 2478 13th St Se, Salem, OR 97302-2546 | 2009-10-28 |
| 1902040355 | Andrea Zeug Stout | Pediatrics | 2478 13th St Se, Salem, OR 97302-2546 | 2009-04-29 |
| 1376745174 | Lindsay Nichole Jaques | Counselor | 2478 13th St Se, Salem, OR 97302-2546 | 2007-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063069300 | Ideal Option Pllc | Clinic/Center | 863 Liberty St Ne, Salem, OR 97301-2451 | 2019-08-21 |
| 1326589771 | Saint Moscati Community Health Care | Clinic/Center | 4131 Glendale Ave Ne, Salem, OR 97305-1913 | 2017-03-18 |
| 1275983660 | Salem Community Acupuncture Project | Clinic/Center | 2416 13th St Se, Salem, OR 97302-2546 | 2016-06-15 |
| 1619341633 | Hkd Treatment Options | Clinic/Center | 84 Highland Ave., Suite 305, Salem, MA 01970 | 2015-11-16 |
| 1770967325 | Dancing Crane Center of Chinese Medicine | Clinic/Center | 11 Library Sq, Salem, VA 24153-3846 | 2015-07-14 |
| 1831504968 | Wvp Medical Group, LLC | Clinic/Center | 2485 12th St. Se, Salem, OR 97302-0000 | 2014-06-27 |
| 1013210095 | Salem Occupational and Acute Care | Clinic/Center | 13 Red Roof Ln Ste 2, Salem, NH 03079-2983 | 2010-12-13 |
| 1336456516 | Salem Free Medical Clinic | Clinic/Center | 1300 Broadway St Ne Suite #104, Salem, OR 97301 | 2010-09-09 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1659524403 | Doctor's Diagnositcs, LLC | Clinic/Center | 322 Highway 62 W, Suite 2, Salem, AR 72576-9566 | 2008-10-24 |
| Find all providers in SALEM | ||||
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| 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.