| Wvp Medical Group, LLC | |
|
5100 River Rd N Keizer OR 97303-5371 | |
| (503) 393-2533 | |
| (503) 393-5978 |
| Full Name | Wvp Medical Group, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5100 River Rd N, Keizer, Oregon |
| Authorized Official Name and Position | Dean Andretta (CFO) |
| Authorized Official Contact | 5033717701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wvp Medical Group, LLC 2995 Ryan Dr Se Ste 200 Salem OR 97301-5157 Ph: (503) 371-7701 | Wvp Medical Group, LLC 5100 River Rd N Keizer OR 97303-5371 Ph: (503) 393-2533 |
| NPI Number | 1750684767 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 04/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750684767 | NPI | - | NPPES |
| 288533 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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