PROVIDENCE HEALTH & SERVICES OREGON (NPI# 1265743330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265743330 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES OREGON |
| Other Organization Name | PROVIDENCE ST VINCENT HEART CLINICS CARDIOLOGY DOCTORS CLINIC SALEM |
| Practice Address |
5050 Skyline Village Loop S Salem OR 97306-9490 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032912123 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2014-11-20 |
| Authorized Official Name | KEENAN B FREEMAN (CFO) |
| Authorized Official Telephone | 5038936524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500630291 | 05 |
| Other Name | Type Code |
|---|---|
| Providence St Vincent Heart Clinics Cardiology Doctors Clinic Salem | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425693 | Providence Health & Services Oregon | Durable Medical Equipment & Medical Supplies | 2296 Nw Kings Blvd Ste 101, Corvallis, OR 97330-3871 | 2019-03-07 |
| 1841756764 | Providence Health & Services Oregon | Family Medicine | 171 N Larch St Ste 16, Cannon Beach, OR 97110-3103 | 2019-02-15 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1922453943 | Providence Health & Services Oregon | Assisted Living Facility | 1550 Brookside Dr, Hood River, OR 97031-8553 | 2016-04-27 |
| 1649541020 | Providence Health & Services Oregon | Clinic/Center | 211 Ne Skyline Dr, White Salmon, WA 98672 | 2012-01-18 |
| 1922330828 | Providence Health & Services Oregon | Pharmacy | 18040 Sw Lower Boones Ferry Rd Ste 104, Tigard, OR 97224-7259 | 2010-02-03 |
| 1801010004 | Providence Health & Services Oregon | Internal Medicine | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2007-04-12 |
| 1487746491 | Providence Health & Services Oregon | Home Health | 2033 Commerce Dr, Medford, OR 97504-9744 | 2006-09-28 |
| 1831196302 | Providence Health & Services Oregon | Home Health | 570 S Main Street, Mount Angel, OR 97362-9540 | 2005-06-30 |
| 1003319724 | Providence Health & Services Oregon | Clinic/Center | 5211 Ne Glisan St Bldg C, Portland, OR 97213-3052 | 2018-03-09 |
| Street Address |
5050 SKYLINE VILLAGE LOOP S |
| City | SALEM |
| State | OR |
| Zip Code | 97306-9490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972586147 | Myron L Lee | Family Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2005-11-22 |
| 1730655820 | Tamara S Mullins | Nurse Practitioner | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2018-10-16 |
| 1982148789 | Wvp Medical Group, LLC | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2016-12-13 |
| 1578908638 | Troy Sterling Nies | Physician Assistant | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2013-05-02 |
| 1174874176 | Grace Whei Kao | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2012-10-01 |
| 1558494294 | Christian Robert Duren | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2007-03-13 |
| 1215094958 | Ragna Kirsten Rey Rosa | Family Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2007-01-02 |
| 1427152818 | Jay Campbell | Family Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2006-09-07 |
| 1649283060 | Heidi Louise Fletemier | Family Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2006-08-15 |
| 1841275393 | Doctors Clinic LLP | Internal Medicine | 5050 Skyline Village Loop S, Salem, OR 97306-9490 | 2005-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
| 1215470315 | Anthony Quoc Ngo | Nurse Practitioner | 5050 Skyline Village Loop, Salem, OR 97306 | 2016-11-22 |
| 1134521305 | Wendy Poling | Occupational Therapy Assistant | 1966 Madras St Se Apt 1082, Salem, OR 97306 | 2014-09-19 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1164685574 | Leon Chira | Pharmacist | 2431 Concomly Rd S, Salem, OR 97306 | 2008-07-07 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
| 1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
| 1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
| Find all providers in zip 97306 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063069300 | Ideal Option Pllc | Clinic/Center | 863 Liberty St Ne, Salem, OR 97301-2451 | 2019-08-21 |
| 1326589771 | Saint Moscati Community Health Care | Clinic/Center | 4131 Glendale Ave Ne, Salem, OR 97305-1913 | 2017-03-18 |
| 1275983660 | Salem Community Acupuncture Project | Clinic/Center | 2416 13th St Se, Salem, OR 97302-2546 | 2016-06-15 |
| 1619341633 | Hkd Treatment Options | Clinic/Center | 84 Highland Ave., Suite 305, Salem, MA 01970 | 2015-11-16 |
| 1770967325 | Dancing Crane Center of Chinese Medicine | Clinic/Center | 11 Library Sq, Salem, VA 24153-3846 | 2015-07-14 |
| 1831504968 | Wvp Medical Group, LLC | Clinic/Center | 2485 12th St. Se, Salem, OR 97302-0000 | 2014-06-27 |
| 1013210095 | Salem Occupational and Acute Care | Clinic/Center | 13 Red Roof Ln Ste 2, Salem, NH 03079-2983 | 2010-12-13 |
| 1336456516 | Salem Free Medical Clinic | Clinic/Center | 1300 Broadway St Ne Suite #104, Salem, OR 97301 | 2010-09-09 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1659524403 | Doctor's Diagnositcs, LLC | Clinic/Center | 322 Highway 62 W, Suite 2, Salem, AR 72576-9566 | 2008-10-24 |
| 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.