OREGON CLINIC PC (NPI# 1417112616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417112616 |
| Entity Type | Organization |
| Organization Name | OREGON CLINIC PC |
| Other Organization Name | NSWA SALEM |
| Practice Address |
875 Oak St Se Suite 5020 Salem OR 97301-3975 |
| Mailing Address |
Po Box 5087 Ms 163 Portland OR 97208-5087 |
| Practice Telephone | 5039632801 |
| Practice Fax Number | 5039632825 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2016-03-29 |
| Authorized Official Name | CRAIG S FAUSEL (CEO PRESIDENT) |
| Authorized Official Telephone | 5039632801 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 160412 | OR | Other Service Providers |
| Other Name | Type Code |
|---|---|
| NSWA Salem | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265417174 | Oregon Clinic PC | Obstetrics & Gynecology | 847 Ne 19th Ave, Suite 300, Portland, OR 97232-2684 | 2005-12-13 |
| 1215586102 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2019-09-04 |
| 1497046205 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 1111 Ne 99th Ave Ste 200, Portland, OR 97220 | 2011-04-27 |
| 1366699464 | Oregon Clinic PC | Specialist | 315 Se Stonemill Dr, Suite 220, Vancouver, WA 98684-6998 | 2008-08-20 |
| 1003944042 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 1111 Ne 99th Avenue, Portland, OR 97220 | 2007-03-01 |
| Street Address |
875 OAK ST SE SUITE 5020 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952307498 | Jerry Leroy Hubbard | Neurological Surgery | 875 Oak St Se, Ste 5060, Salem, OR 97301-3987 | 2005-06-21 |
| 1710447453 | Katie Joy Larue | Pharmacist | 875 Oak St Se, Salem, OR 97301-3975 | 2019-03-20 |
| 1538600333 | Rachel Wixson | Nurse Practitioner | 875 Oak St Se, Salem, OR 97301-3975 | 2017-03-13 |
| 1265971386 | Angela Rehder | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301 | 2017-02-22 |
| 1548625585 | Hematology Oncology of Salem, LLP | Physician Assistant | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-12-17 |
| 1841664752 | Healogics Specialty Physicians of Oregon, LLC | Emergency Medicine | 875 Oak St Se, Salem, OR 97301-3975 | 2015-11-17 |
| 1134592041 | Oregon Oncology Specialists, LLP | Internal Medicine | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-11-02 |
| 1841693363 | Charles V. Hatchette II, Md, LLC | Neurological Surgery | 875 Oak St Se, Suite 5060, Salem, OR 97301-3975 | 2014-09-29 |
| 1770997009 | Urooba Faheem | Psychiatry & Neurology | 875 Oak St Se, Salem, OR 97301-3975 | 2014-06-14 |
| 1689922676 | Michael Christian Slabaugh | Physician Assistant | 875 Oak St Se, Ste 3010, Salem, OR 97301 | 2012-08-22 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265970495 | Deanna Lauren Carter | Specialist | 9 Muse Ter, Salem, NH 03079-2921 | 2017-02-08 |
| 1043763980 | Michael Tre Cline Jr. | Specialist | 1505 Whitaker Dr Se, #201, Salem, OR 97317-5912 | 2016-07-27 |
| 1508213604 | Amy Masters | Specialist | 23190 Zieber Ln Nw, Salem, OR 97304-9631 | 2016-05-18 |
| 1417326398 | Lisa K Breslin | Specialist | 27 Congress St Ste 203, Salem, MA 01970-5576 | 2015-09-21 |
| 1588048656 | Carl Bettencourt | Specialist | 67 Wharf St, Salem, MA 01970-5116 | 2015-07-17 |
| 1689066250 | Maxine Trujillo | Specialist | 191 Mcnary Ave Nw, Salem, OR 97304-4037 | 2015-02-19 |
| 1619379633 | Wanda Getz | Specialist | 4275 Commercial St Se, Salem, OR 97302-4086 | 2014-09-22 |
| 1255753174 | Janette Toll | Specialist | 1898 Court St Ne, Salem, OR 97301-4328 | 2014-01-12 |
| 1912333741 | Melanie A Ground | Specialist | 1967 Brightwood Ct S, Salem, OR 97302-2405 | 2013-09-25 |
| 1245662410 | Kenneth M. Wilson, M.d., P.C. | Specialist | 700 Bellevue St Se Ste 260, Salem, OR 97301-3888 | 2013-07-30 |
| 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.