SALEM CLINIC, PC (NPI# 1962781526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962781526 |
Entity Type | Organization |
Organization Name | SALEM CLINIC, PC |
Practice Address |
1174 Cornucopia St Nw Ste 120 Salem OR 97304-3193 |
Mailing Address |
Po Box 8100 Salem OR 97303-0900 |
Practice Telephone | 5033992424 |
Practice Fax Number | 5033757429 |
Mailing Telephone | 5033992470 |
Mailing Fax Number | 5033757429 |
Enumeration Date | 2011-08-12 |
Last Update Date | 2011-08-12 |
Authorized Official Name | MS. BARBARA GUNDER (ADMINISTRATOR/CAO) |
Authorized Official Telephone | 5033992470 |
Authorized Official Credential | CAO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 179051 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
1992973622 | Salem Clinic, PC | General Practice | 5900 Inland Shores Way N, Keizer, OR 97303-3795 | 2008-02-15 |
1538337266 | Salem Clinic, PC | General Practice | 1165 Union St Ne, Salem, OR 97301-4693 | 2008-02-15 |
1912935594 | Salem Clinic, PC | General Practice | 2020 Capitol St Ne, Salem, OR 97303-3244 | 2006-06-30 |
Street Address |
1174 CORNUCOPIA ST NW STE 120 |
City | SALEM |
State | OR |
Zip Code | 97304-3193 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275574113 | Kathryn L Lueken | Family Medicine | 1174 Cornucopia St Nw Ste 120, Salem, OR 97304-3193 | 2006-06-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
Find all providers in zip 97304 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821342429 | Stephanie Nicole Reedy | General Practice | 2515 Liberty St Ne, Salem, OR 97301-8386 | 2012-11-04 |
1427207265 | John M Vargo | General Practice | 4305 Camas Ct Ne, Salem, OR 97305-2207 | 2008-09-17 |
1275797417 | Lagrand Johnson | General Practice | 326 Highway 6, Salem, UT 84653-5620 | 2008-07-16 |
1235392242 | John Mark Pozar | General Practice | 998 Capitol St Ne, Salem, OR 97301-1201 | 2008-07-09 |
1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
1104028364 | Ivan Dassenko | General Practice | 6810 Canyon St Se, Salem, OR 97317-9024 | 2007-06-01 |
1073668935 | Terence H Young | General Practice | 1205 Wallace Rd Nw, Salem, OR 97304-3007 | 2007-01-23 |
1639243348 | Thomas R Howard | General Practice | 567 Salem Quinton Rd, Ste C, Salem, NJ 08079-1255 | 2006-11-17 |
1023083722 | Brent K. Caudill | General Practice | Hwy 72 N, Salem, MO 65560 | 2006-02-17 |
1316456965 | Anton Dubrick Md Sc | General Practice | 420 W Schwartz St, Salem, IL 62881-1552 | 2017-09-27 |
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.