WILLAMETTE VASCULAR SPECIALISTS, PC (NPI# 1225351901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225351901 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE VASCULAR SPECIALISTS, PC |
| Practice Address |
1015 25th St Se Salem OR 97301 |
| Mailing Address |
Po Box 12707 Salem OR 97309-0707 |
| Practice Telephone | 5035617227 |
| Practice Fax Number | 5035617272 |
| Mailing Telephone | 5035617227 |
| Mailing Fax Number | 5035617272 |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2011-03-08 |
| Authorized Official Name | MARK S PETERSON (OWNER) |
| Authorized Official Telephone | 5035617227 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD16135 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
1015 25TH ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518588904 | Shannon Alfonso | Nurse Practitioner | 1015 25th St Se, Salem, OR 97301-5049 | 2020-04-27 |
| 1316423734 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 1015 25th St Se, Salem, OR 97301-5049 | 2018-07-18 |
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174756605 | Benjamin R. Wilson, Md, PC | Surgery | 700 Bellevue Street, Suite 240, Salem, OR 97301-3855 | 2009-09-01 |
| 1508074147 | Salem Vascular Consultants, LLP | Surgery | 1535 Liberty St Se, Salem, OR 97302-4345 | 2007-05-18 |
| 1356726418 | Advanced Vascular Therapy LLC | Surgery | 2480 Liberty St Ne, Suite 110, Salem, OR 97301-8380 | 2015-07-29 |
| 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 |
| 1831411560 | Salem Vascular, PC | Surgery | 1535 Liberty St Se, Salem, OR 97302-4345 | 2010-02-22 |
| 1326207739 | Amani D Politano | Surgery | 875 Oak St Se Ste 5020, Salem, OR 97301-3997 | 2008-06-02 |
| 1104990175 | Rick Dewitt Pittman | Surgery | 1793 13th St Se, Salem, OR 97302-2541 | 2006-11-20 |
| 1003980053 | Mark Steven Peterson | Surgery | 925 Commercial St Se Ste 102, Salem, OR 97302-4173 | 2006-11-20 |
| 1578596938 | William Siao-ping Tung | Surgery | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2006-07-09 |
| 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.