| 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 | () | 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 Melton 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 | Zoryana N Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285815985 PECOS PAC ID: 3870673437 Enrollment ID: I20080108000832 |
| 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 | Piper Rooke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760565303 PECOS PAC ID: 6002982089 Enrollment ID: I20090825000155 |
| 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 | Mario J Diaz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164460697 PECOS PAC ID: 7911049564 Enrollment ID: I20100121000091 |
| Provider Name | Erik G Bates |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689786832 PECOS PAC ID: 9931114428 Enrollment ID: I20100216000115 |
| 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 | Kristen L Dodd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043540669 PECOS PAC ID: 7719068782 Enrollment ID: I20100715000611 |
| 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 | 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 | Julie D Crownover |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174891311 PECOS PAC ID: 3173790037 Enrollment ID: I20130305000484 |
| 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 | Christopher F Killen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083950885 PECOS PAC ID: 4486895166 Enrollment ID: I20130723000153 |
| 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 | Tauni R Carter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811292170 PECOS PAC ID: 4385874213 Enrollment ID: I20140815002105 |
| Provider Name | Erica E Akbari |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659700029 PECOS PAC ID: 7618106642 Enrollment ID: I20140918002579 |
| 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 | Joshua J Knight |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316272875 PECOS PAC ID: 8123272556 Enrollment ID: I20150623002382 |
| Provider Name | Nicholas Hanson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356568661 PECOS PAC ID: 2860582889 Enrollment ID: I20160129001615 |
| Provider Name | Lauren Hodgson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104236371 PECOS PAC ID: 1658677265 Enrollment ID: I20160308001886 |
| 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 Robert 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 | William L Seibt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225401920 PECOS PAC ID: 7810255379 Enrollment ID: I20171211002954 |
| 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 | Jessica L Brooks |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487152948 PECOS PAC ID: 8820344450 Enrollment ID: I20180711002922 |
| 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 | Shannon Jean Lemay |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255804233 PECOS PAC ID: 3173863727 Enrollment ID: I20190319002272 |
| Provider Name | Jamie E Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235587668 PECOS PAC ID: 0547548786 Enrollment ID: I20190725003449 |
| 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 | Hazel Jade Milano Tetzlaff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306494638 PECOS PAC ID: 7618300047 Enrollment ID: I20191125003015 |
| Provider Name | Kristi Souza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083255541 PECOS PAC ID: 6800229253 Enrollment ID: I20191126000801 |
| Provider Name | Brent D Grauerholz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881672756 PECOS PAC ID: 6608917364 Enrollment ID: I20200212000688 |
| Provider Name | Katherine M Zuber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396386967 PECOS PAC ID: 3476981556 Enrollment ID: I20200324001897 |
| 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 | Kelsey Locken |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679107841 PECOS PAC ID: 5092126540 Enrollment ID: I20201204001452 |
| Provider Name | Johanna Eppelsheimer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457916827 PECOS PAC ID: 2365853827 Enrollment ID: I20201204001876 |
| 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 | Tara Westby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932720711 PECOS PAC ID: 4183017015 Enrollment ID: I20220216002701 |
| 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 | Yoon-jin Kim |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1407210461 PECOS PAC ID: 2466856661 Enrollment ID: I20220719000392 |
| Provider Name | Joshua Cole Gratwohl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386370898 PECOS PAC ID: 5496130924 Enrollment ID: I20220919002647 |
| Provider Name | Samantha Anne 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 | Audrey L Vetter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447027263 PECOS PAC ID: 1951740877 Enrollment ID: I20240411002755 |
| 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 | Leslie Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437713369 PECOS PAC ID: 1557762739 Enrollment ID: I20240830001378 |
| Provider Name | Madison Rose Kerzel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144062142 PECOS PAC ID: 6800337791 Enrollment ID: I20240918004297 |
| Provider Name | Mikael Aragon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740026459 PECOS PAC ID: 0244771590 Enrollment ID: I20240926001329 |
| Provider Name | Catlin Nicole Flynn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902403132 PECOS PAC ID: 6507278272 Enrollment ID: I20250609002384 |
| Provider Name | David Venincasa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750844841 PECOS PAC ID: 7719217314 Enrollment ID: I20250710002316 |
| Provider Name | Hana R Ehmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194518746 PECOS PAC ID: 9739695537 Enrollment ID: I20250718002970 |
| Provider Name | Anthony Michael Martz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003566902 PECOS PAC ID: 1456796481 Enrollment ID: I20250807003424 |
| Provider Name | Christopher T Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184368615 PECOS PAC ID: 6002334935 Enrollment ID: I20250825001913 |
| Provider Name | Stacey Jesser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326454166 PECOS PAC ID: 3971897505 Enrollment ID: I20250826004474 |
| Provider Name | Hanna P Berlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316527161 PECOS PAC ID: 4385052182 Enrollment ID: I20250905003635 |
| Provider Name | Samantha Sondermayer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205465432 PECOS PAC ID: 5991143919 Enrollment ID: I20250911002576 |
| Provider Name | Logan Carson Bret Mcintire |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538902481 PECOS PAC ID: 4284139270 Enrollment ID: I20250922003000 |
| Provider Name | Michelle Lea Keller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003323809 PECOS PAC ID: 4688160773 Enrollment ID: I20251227000639 |
| Provider Name | Abirami Rajasegaran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396331856 PECOS PAC ID: 4284039520 Enrollment ID: I20260528003556 |
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 |
Alante Primary Care O LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1220 20th St Se Ste 310, Salem, OR 97302 Phone: 480-631-4978 Fax: 844-443-4378 |
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 |
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 |
Corban University Student Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Deer Park Dr Se, Salem, OR 97317 Phone: 503-589-8101 |