PACIFIC PATHOLOGY ASSOCIATES, INC. (NPI# 1205997889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205997889 |
| Entity Type | Organization |
| Organization Name | PACIFIC PATHOLOGY ASSOCIATES, INC. |
| Practice Address |
665 Winter St Se Salem OR 97301-3934 |
| Mailing Address |
5700 Southwyck Blvd Toledo OH 43614-1509 |
| Practice Telephone | 5035615350 |
| Practice Fax Number | 5035614781 |
| Mailing Telephone | 8002888325 |
| Mailing Fax Number | 4198665453 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2014-12-10 |
| Authorized Official Name | CLARK E MCDONALD (PRESIDENT) |
| Authorized Official Telephone | 5035615564 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | 38D0625543 | OR | Laboratories |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 006465 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC PATHOLOGY ASSOCIATES, INC. | 665 Winter Street Se, Salem, OR 97301 |
| Street Address |
665 WINTER ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659372407 | Raghunandan Kamineni | Internal Medicine | 665 Winter St Se, Suite B0350, Salem, OR 97301-3934 | 2005-08-02 |
| 1356842207 | Emily Stahl Mollenkopf | Registered Nurse | 665 Winter St Se, Salem, OR 97301-3934 | 2018-02-26 |
| 1083166037 | Courtney E Brozovich | Physician Assistant | 665 Winter St Se, Salem, OR 97301-3934 | 2016-10-25 |
| 1215304092 | Caroline Houston | Pharmacist | 665 Winter St Se, Salem, OR 97301-3934 | 2015-08-27 |
| 1982008983 | Julian Mark Williams | Perfusionist | 665 Winter St Se, Salem, OR 97301-3934 | 2014-10-20 |
| 1366861775 | Andrew W Judd | Pathology | 665 Winter St Se, Bldg B 2nd Floor Pathology, Salem, OR 97301-3934 | 2014-04-14 |
| 1215215371 | Atish Chopra | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-07-23 |
| 1003106071 | Jeffrey David Crawford | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-04-12 |
| 1528357795 | Mariko Aili Ferronato | Surgery | 665 Winter St Se, Salem, OR 97301-3934 | 2011-03-28 |
| 1174848162 | Trang Nguyen Moore | Internal Medicine | 665 Winter St Se, Salem, OR 97301-3934 | 2010-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932129004 | Wayne Joseph Torre | Pathology | Va Medical Center, 1970 Roanoke Blvd, Bldg 143 Rm Ifg 145a, Pathology, Salem, VA 24153 | 2006-07-20 |
| 1366861775 | Andrew W Judd | Pathology | 665 Winter St Se, Bldg B 2nd Floor Pathology, Salem, OR 97301-3934 | 2014-04-14 |
| 1205157542 | Julie Y Tse | Pathology | 81 Highland Avenue, Salem, MA 01970 | 2010-06-22 |
| 1104085208 | Jennifer Kaplan Kerner | Pathology | 81 Highland Ave, Department of Pathology, Salem, MA 01970-2714 | 2008-06-03 |
| 1215057880 | Wenxue Xing | Pathology | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2007-03-29 |
| 1578628400 | David Bruce Nash | Pathology | 1995 E State St, Salem, OH 44460-2423 | 2006-12-22 |
| 1205997897 | Pamela P Smith | Pathology | 665 Winter St Se, Salem, OR 97301-3934 | 2006-12-13 |
| 1639240195 | Melissa Lou Beal | Pathology | 665 Winter St Se, Salem, OR 97301-3919 | 2006-11-13 |
| 1730265265 | Daryl G Vogel | Pathology | 665 Winter Street Se, Salem, OR 97301-3934 | 2006-10-27 |
| 1467490755 | Bruce A Beckwith | Pathology | 81 Highland Ave, Nsmc Pathology Department, Salem, MA 01970-2714 | 2006-06-02 |
| 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.