DR. FARA KATRINA ETZEL (NPI# 1770525263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770525263 |
Entity Type | Individual |
Full Name | DR. FARA KATRINA ETZEL |
Credential | M.D. |
Practice Address |
2395 Center St Ne Salem OR 97301-4464 |
Practice Telephone | 5033642181 |
Practice Fax Number | 5033640364 |
Mailing Telephone | 5033642181 |
Mailing Fax Number | 5033640364 |
Enumeration Date | 2006-06-11 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | MD23500 | OR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 182833 | 05 |
Street Address |
2395 CENTER ST NE |
City | SALEM |
State | OR |
Zip Code | 97301-4464 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992731343 | James Kenneth Lace | Pediatrics | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-25 |
1396781605 | Jon Michael Gilbert | Pediatrics | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-22 |
1053353649 | Marge L Dettwiler | Nurse Practitioner | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
Find all providers in zip 97301 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730440058 | Matthew Hatler | Pediatrics | 2478 13th St. Se, Salem, OR 97302-2546 | 2012-06-04 |
1033409016 | William Christopher Thomsen Jr. | Pediatrics | 1641 Millwood Dr, Salem, VA 24153-4616 | 2011-04-12 |
1275708539 | Children's Medical Group | Pediatrics | 24906 75th St, Salem, WI 53168-9705 | 2008-04-28 |
1346378213 | Cooper Pediatrics | Pediatrics | 330 Woodstown Road., Medical Arts Bldg 7, Salem, NJ 08079 | 2007-03-01 |
1053424291 | Linda J Morgan | Pediatrics | 57 Highlands Ave, Er, Salem, MA 01970 | 2006-08-15 |
1700813854 | Dorin Meredith Kemmerle | Pediatrics | 4350 Commercial St Se, Salem, OR 97302-3914 | 2006-06-26 |
1043252612 | Kimberly Ann Heggen | Pediatrics | 891 23rd St Ne, Salem, OR 97301-1793 | 2006-06-11 |
1083675953 | Donald T Mcauliffe | Pediatrics | 72 Highland Avenue, Pediatric Associates of Greater Salem, Salem, MA 01970 | 2006-03-30 |
1336116474 | Madeleine Ana Ortiz | Pediatrics | 1076 E State St, Salem, OH 44460-2228 | 2006-03-08 |
1104813062 | Edward Zalitis | Pediatrics | 72 Highland Ave, Salem, MA 01970-2738 | 2005-10-05 |
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.