| Mill Creek Family Clinic Inc | |
|
4285 Commercial St Se Suite 120 Salem OR 97302-4371 | |
| (503) 391-6615 | |
| Not Available |
| Full Name | Mill Creek Family Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4285 Commercial St Se, Salem, Oregon |
| Authorized Official Name and Position | Peggy Nelene Kelber (OFFICE MANAGER) |
| Authorized Official Contact | 5033916615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mill Creek Family Clinic Inc 4285 Commercial St Se Suite 120 Salem OR 97302-4371 Ph: (503) 931-2948 | Mill Creek Family Clinic Inc 4285 Commercial St Se Suite 120 Salem OR 97302-4371 Ph: (503) 391-6615 |
| NPI Number | 1114299153 |
|---|---|
| Provider Enumeration Date | 02/07/2012 |
| Last Update Date | 05/02/2012 |
| Medicare PECOS PAC ID | 3678739240 |
|---|---|
| Medicare Enrollment ID | O20120725001130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114299153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | NP135211 (Oregon) | Primary |
| Provider Name | Sheila L Wettlaufer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679513493 PECOS PAC ID: 7517032824 Enrollment ID: I20080821000265 |
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