| Salem Clinic, Pc | |
|
2020 Capitol St Ne Salem OR 97303-3244 | |
| (503) 399-2470 | |
| (503) 375-7429 |
| Full Name | Salem Clinic, Pc |
|---|---|
| Speciality | General Practice |
| Location | 2020 Capitol St Ne, Salem, Oregon |
| Authorized Official Name and Position | Barbara Gunder (ADMINISTRATOR/CAO) |
| Authorized Official Contact | 5033992470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salem Clinic, Pc Po Box 8100 Salem OR 97303-0900 Ph: (503) 399-2470 | Salem Clinic, Pc 2020 Capitol St Ne Salem OR 97303-3244 Ph: (503) 399-2470 |
| NPI Number | 1912935594 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 12/06/2016 |
| Medicare PECOS PAC ID | 7517954514 |
|---|---|
| Medicare Enrollment ID | O20040430000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912935594 | NPI | - | NPPES |
| 500400275 | Medicaid | OR | |
| 179051 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Martin L Bassett |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1437163029 PECOS PAC ID: 9537066972 Enrollment ID: I20031215000724 |
| Provider Name | Michael J George |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922050236 PECOS PAC ID: 3173504826 Enrollment ID: I20040527000909 |
| Provider Name | Jose O Novoa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417908757 PECOS PAC ID: 6002897790 Enrollment ID: I20040527001213 |
| Provider Name | Sean P Stack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962453217 PECOS PAC ID: 2860473311 Enrollment ID: I20040528001105 |
| Provider Name | Richard D Collins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710939186 PECOS PAC ID: 3577544055 Enrollment ID: I20040528001266 |
| Provider Name | Stephen L Burrows |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841241106 PECOS PAC ID: 2264413749 Enrollment ID: I20040528001296 |
| Provider Name | Michael M Pass |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326090762 PECOS PAC ID: 8123072147 Enrollment ID: I20050311000348 |
| Provider Name | David C Harrison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144272527 PECOS PAC ID: 8325088420 Enrollment ID: I20050509000470 |
| Provider Name | Raymond M Baculi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558302307 PECOS PAC ID: 7416980776 Enrollment ID: I20050916000212 |
| Provider Name | Amit Bhandari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669456448 PECOS PAC ID: 9032134689 Enrollment ID: I20051012000756 |
| Provider Name | Niels F Pedersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740251537 PECOS PAC ID: 0244234623 Enrollment ID: I20060828000401 |
| Provider Name | Jiyoun Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053400713 PECOS PAC ID: 2860402245 Enrollment ID: I20061117000493 |
| Provider Name | Travis E Fromwiller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184671620 PECOS PAC ID: 8123030145 Enrollment ID: I20070525000453 |
| Provider Name | Sandi R Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700074663 PECOS PAC ID: 8123115292 Enrollment ID: I20071106000621 |
| Provider Name | Catherine A Boulay |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720029556 PECOS PAC ID: 1254343668 Enrollment ID: I20071108000605 |
| Provider Name | Mori J Montagne |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730284027 PECOS PAC ID: 3870595366 Enrollment ID: I20071212000446 |
| Provider Name | Jared R Sadler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699814665 PECOS PAC ID: 7214015452 Enrollment ID: I20080429000210 |
| Provider Name | Yuen M Chau |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255427449 PECOS PAC ID: 1658464904 Enrollment ID: I20080619000733 |
| Provider Name | Sheila D Goldsworthy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700872918 PECOS PAC ID: 9638135742 Enrollment ID: I20080904000762 |
| Provider Name | Michael P Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245449099 PECOS PAC ID: 3274697016 Enrollment ID: I20090123000054 |
| Provider Name | Kyu Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992825475 PECOS PAC ID: 4688727142 Enrollment ID: I20090730000360 |
| Provider Name | Jared C Eller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417947367 PECOS PAC ID: 7517013741 Enrollment ID: I20090914000232 |
| Provider Name | Darcy L Blanchard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588770325 PECOS PAC ID: 1355340571 Enrollment ID: I20091006000373 |
| Provider Name | Laura J Chong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831133313 PECOS PAC ID: 6608819180 Enrollment ID: I20091222000177 |
| Provider Name | Frederick H Frank |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205870334 PECOS PAC ID: 3375625817 Enrollment ID: I20091222000238 |
| Provider Name | Timothy T Zuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770524167 PECOS PAC ID: 0345322889 Enrollment ID: I20100106000663 |
| Provider Name | Paul E Huun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700824810 PECOS PAC ID: 8022051507 Enrollment ID: I20100106000714 |
| Provider Name | Mark R Fischl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558302984 PECOS PAC ID: 0042253528 Enrollment ID: I20100106000756 |
| Provider Name | Stephen A Carp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881638310 PECOS PAC ID: 7113009655 Enrollment ID: I20100113000052 |
| Provider Name | Jeffrey S Stoessl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437192945 PECOS PAC ID: 9638112121 Enrollment ID: I20100113000084 |
| Provider Name | Ian G Loewen Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447299227 PECOS PAC ID: 4486697976 Enrollment ID: I20100113000108 |
| Provider Name | John P Daniels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518909506 PECOS PAC ID: 9234172719 Enrollment ID: I20100113000133 |
| Provider Name | Gregory A Lackides |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770522690 PECOS PAC ID: 0840233326 Enrollment ID: I20100113000164 |
| Provider Name | Ryan K Cooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700994399 PECOS PAC ID: 4486687530 Enrollment ID: I20100217000406 |
| Provider Name | Heather J Burgin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912947334 PECOS PAC ID: 1355384835 Enrollment ID: I20100224000744 |
| Provider Name | Rajan V Nair |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871532762 PECOS PAC ID: 8921041419 Enrollment ID: I20100224000808 |
| Provider Name | William Gillespie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497797310 PECOS PAC ID: 9032152517 Enrollment ID: I20100224000830 |
| Provider Name | Johan Lg Kohler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245355643 PECOS PAC ID: 9931196565 Enrollment ID: I20100630000419 |
| Provider Name | John K Bradshaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679734354 PECOS PAC ID: 8820140270 Enrollment ID: I20100714000890 |
| Provider Name | Gerald E Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124271002 PECOS PAC ID: 0042403362 Enrollment ID: I20101019001291 |
| Provider Name | Robert L Sloan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427062223 PECOS PAC ID: 9638362502 Enrollment ID: I20101023000142 |
| Provider Name | Susan H Tran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982633228 PECOS PAC ID: 6901860766 Enrollment ID: I20101130000397 |
| Provider Name | Kathleen M Harder |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164406336 PECOS PAC ID: 4688630080 Enrollment ID: I20101215000652 |
| Provider Name | Christian A Devaux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770613747 PECOS PAC ID: 3476735002 Enrollment ID: I20110901000344 |
| Provider Name | Warren I Okuns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134385461 PECOS PAC ID: 5698949717 Enrollment ID: I20111129000298 |
| Provider Name | Earl W Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427287408 PECOS PAC ID: 0143485540 Enrollment ID: I20120710000675 |
| Provider Name | Steven H Samawi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629229216 PECOS PAC ID: 0244481653 Enrollment ID: I20121113000182 |
| Provider Name | Valerie J Joyce Heffner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588807259 PECOS PAC ID: 4880834373 Enrollment ID: I20130703000701 |
| Provider Name | Scott H Ambruster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760686505 PECOS PAC ID: 5496810681 Enrollment ID: I20130718000415 |
| Provider Name | Volodymyr Y Dovhyy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003049818 PECOS PAC ID: 8426297268 Enrollment ID: I20130912000385 |
| Provider Name | Praneet K Nanduri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831404367 PECOS PAC ID: 6507091196 Enrollment ID: I20131107000955 |
| Provider Name | Maxwell B Abbott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174535090 PECOS PAC ID: 9234126814 Enrollment ID: I20140702001436 |
| Provider Name | Stephanie E Dukhovny |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801054531 PECOS PAC ID: 5597889808 Enrollment ID: I20141002002193 |
| Provider Name | Shahab Akbari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326473133 PECOS PAC ID: 8426275520 Enrollment ID: I20141016001456 |
| Provider Name | Tom Shi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538454723 PECOS PAC ID: 2860613460 Enrollment ID: I20141023002505 |
| Provider Name | Mark Harrington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740254556 PECOS PAC ID: 7416095252 Enrollment ID: I20150213001776 |
| Provider Name | Kathryn B. Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922327626 PECOS PAC ID: 9931354578 Enrollment ID: I20150523000050 |
| Provider Name | Nicholas Hanson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356568661 PECOS PAC ID: 2860582889 Enrollment ID: I20160129001615 |
| Provider Name | Thomas Cullen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124347117 PECOS PAC ID: 9739470220 Enrollment ID: I20160613002133 |
| Provider Name | Yama Kharoti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386961712 PECOS PAC ID: 0446405195 Enrollment ID: I20160629001917 |
| Provider Name | Nirmal Bastola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730310830 PECOS PAC ID: 3678738895 Enrollment ID: I20170315002278 |
| Provider Name | Tyler R Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710252036 PECOS PAC ID: 9537301627 Enrollment ID: I20170524001311 |
| Provider Name | Stephanie A Navaja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972913275 PECOS PAC ID: 1658695614 Enrollment ID: I20170607000495 |
| Provider Name | Cameron M Saffer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174940050 PECOS PAC ID: 5092012906 Enrollment ID: I20170804002211 |
| Provider Name | Rebecca L Collins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215376173 PECOS PAC ID: 0042434805 Enrollment ID: I20170912001070 |
| Provider Name | Philip C Skelding |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336323088 PECOS PAC ID: 9436204435 Enrollment ID: I20171025002463 |
| Provider Name | Ryan Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659639557 PECOS PAC ID: 6002170248 Enrollment ID: I20180516000113 |
| Provider Name | Rishi Ram Pathak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982850152 PECOS PAC ID: 0941470124 Enrollment ID: I20180627001250 |
| Provider Name | Gregory L Pirkl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255591962 PECOS PAC ID: 8729220132 Enrollment ID: I20180918002754 |
| Provider Name | Moti L Vishwakarma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790974145 PECOS PAC ID: 2769675057 Enrollment ID: I20181121001780 |
| Provider Name | Tamara S Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730655820 PECOS PAC ID: 8729326830 Enrollment ID: I20190215001131 |
| Provider Name | Marilyn Halder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619138351 PECOS PAC ID: 1254519879 Enrollment ID: I20190301001709 |
| Provider Name | Allison C Musillami |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801125687 PECOS PAC ID: 8921335738 Enrollment ID: I20190815002883 |
| Provider Name | Brent D Grauerholz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881672756 PECOS PAC ID: 6608917364 Enrollment ID: I20200212000688 |
| Provider Name | David Prosser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174940126 PECOS PAC ID: 0345569372 Enrollment ID: I20200526002303 |
| Provider Name | Jessica M Hoyle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326454885 PECOS PAC ID: 4587970405 Enrollment ID: I20200603001853 |
| Provider Name | Jason Hedge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053721258 PECOS PAC ID: 1254648223 Enrollment ID: I20200603001883 |
| Provider Name | Jake W Sharp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720465933 PECOS PAC ID: 0749597300 Enrollment ID: I20210507002470 |
| Provider Name | Peter A White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417341710 PECOS PAC ID: 2264748664 Enrollment ID: I20210615000770 |
| Provider Name | William E Graven |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871095901 PECOS PAC ID: 3072854132 Enrollment ID: I20210804003093 |
| Provider Name | Jasper D Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295237899 PECOS PAC ID: 8224427414 Enrollment ID: I20211109002152 |
| Provider Name | Kristen Nicole Mccammon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1780283572 PECOS PAC ID: 1759796733 Enrollment ID: I20220425000992 |
| Provider Name | Samantha A Easterly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003473380 PECOS PAC ID: 6103297627 Enrollment ID: I20230120000656 |
| Provider Name | Karen K Terry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942566898 PECOS PAC ID: 6002040136 Enrollment ID: I20230605001621 |
| Provider Name | Kelly Megan Donovan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518470640 PECOS PAC ID: 1355704420 Enrollment ID: I20230823001910 |
| Provider Name | Zoe Charlotte Frank |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285299453 PECOS PAC ID: 0143660142 Enrollment ID: I20240424001615 |
| Provider Name | Matthew Tyler Casper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982450987 PECOS PAC ID: 0446793459 Enrollment ID: I20240619000332 |
| Provider Name | Mikael Aragon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740026459 PECOS PAC ID: 0244771590 Enrollment ID: I20240926001329 |
Life Balance Acupuncture Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 Liberty St Ne, Salem, OR 97301 Phone: 503-881-8996 | |
West Salem Family Practice Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1275 Wallace Rd Nw, Salem, OR 97304 Phone: 503-371-3232 Fax: 503-375-2398 | |
Salem Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 Bellevue St Se, Salem, OR 97301 Phone: 503-814-5554 | |
Oregon Oncology Specialists, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 875 Oak St Se, Suite 4030, Salem, OR 97301 Phone: 503-561-6444 Fax: 503-561-6442 | |
New Focus Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5560 Witzel Rd Se, Salem, OR 97317 Phone: 503-581-8251 Fax: 503-363-8543 | |
Santiam Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Deer Park Dr Se, Salem, OR 97317 Phone: 503-589-8101 | |
Phoenix Rising Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 Commercial St Se, Salem, OR 97302 Phone: 971-227-1073 |