NORTHWEST LIFESTYLE MEDICINE, INC. (NPI# 1447481866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447481866 |
| Entity Type | Organization |
| Organization Name | NORTHWEST LIFESTYLE MEDICINE, INC. |
| Practice Address |
6250 Commercial St Se Suite 100 Salem OR 97306-1333 |
| Mailing Address |
Po Box 4141 Salem OR 97302-8141 |
| Practice Telephone | 9719835433 |
| Practice Fax Number | 9719835434 |
| Mailing Telephone | 9719835433 |
| Mailing Fax Number | 9719835434 |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2015-12-29 |
| Authorized Official Name | DR. MARCUS A BRAMAN (PRESIDENT) |
| Authorized Official Telephone | 9719835433 |
| Authorized Official Credential | MD, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
MD21630 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500656754 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | NORTHWEST LIFESTYLE MEDICINE, INC. | 6250 Commercial St Se, Suite 100a, Salem, OR 97306 |
| Street Address |
6250 COMMERCIAL ST SE SUITE 100 |
| City | SALEM |
| State | OR |
| Zip Code | 97306-1333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629065974 | Marcus Allan Braman | Preventive Medicine | 6250 Commercial St Se, Suite 100, Salem, OR 97306-1333 | 2005-10-03 |
| 1689137663 | Sungjin Kim | Physical Therapist | 6250 Commercial St Se, Salem, OR 97306-2988 | 2019-04-08 |
| 1104304021 | Angela Foster | Physical Therapist | 6250 Commercial St Se, Salem, OR 97306-2988 | 2018-08-02 |
| 1356855753 | Kyle James Alexander | Physical Therapist | 6250 Commercial St Se, Salem, OR 97306-2988 | 2017-11-21 |
| 1265972590 | Jessica O'hara Allen | Physical Therapist | 6250 Commercial St Se, Salem, OR 97306-2988 | 2017-03-06 |
| 1699217414 | Jaemie Joann Fletcher | Massage Therapist | 6250 Commercial St Se, Salem, OR 97306-2988 | 2016-11-10 |
| 1598115040 | Benchmark Physical Therapy of Oregon LLC | Massage Therapist | 6250 Commercial St Se, Salem, OR 97306-1333 | 2016-06-15 |
| 1386093383 | Courtney M Hanson | Physical Therapy Assistant | 6250 Commercial St Se, Salem, OR 97306-1333 | 2016-06-09 |
| 1689023715 | Czarina L Gupton | Physical Therapy Assistant | 6250 Commercial St Se, Salem, OR 97306-1333 | 2016-06-09 |
| 1194174334 | Brian R Dirkx | Physical Therapy Assistant | 6250 Commercial St Se, Salem, OR 97306-1333 | 2016-06-08 |
| 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 | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| 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 Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387791 | Salem City Health District | Preventive Medicine | 230 N Lincoln Ave Ste 104, Salem, OH 44460-2950 | 2019-10-17 |
| 1629065974 | Marcus Allan Braman | Preventive Medicine | 6250 Commercial St Se, Suite 100, Salem, OR 97306-1333 | 2005-10-03 |
| 1205054947 | Karen Ann Landers | Preventive Medicine | 3180 Center St Ne, Salem, OR 97301-4532 | 2007-04-20 |
| 1003868456 | Jasbir Mavi | Preventive Medicine | 1970 Roanoke Blvd, Vamc Salem, Salem, VA 24153-6404 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689020968 | James Anthony Gaudino Jr. | Preventive Medicine | 9061 Sw 38th Ave, Portland, OR 97219-5382 | 2016-05-05 |
| 1467833012 | Beth Hirschfield | Preventive Medicine | 3916 Sw Nevada Ct, Portland, OR 97219-1514 | 2015-06-09 |
| 1316253685 | Richard Howard Cohen | Preventive Medicine | 61243 Gorge View St, Bend, OR 97702-3032 | 2010-08-25 |
| 1073745790 | Susan Mccall | Preventive Medicine | 22260 Sw 102nd Pl, Tualatin, OR 97062-7199 | 2009-08-13 |
| 1568664829 | Andrea Girman | Preventive Medicine | 1905 Ne Wygant St, Portland, OR 97211-5865 | 2007-05-31 |
| 1598978959 | Sharon Elizabeth Smith | Preventive Medicine | 12066 Se 35th Ave., Milwaukie, OR 97222-6830 | 2007-05-08 |
| 1578782678 | Michael Allen Korpa | Preventive Medicine | 1390 Biddle Rd, Medford, OR 97504-4169 | 2007-04-25 |
| 1215153234 | Geoffrey Enochs Beasley | Preventive Medicine | 3181 Sw Sw Sam Jackson Park Rd., Portland, OR 97219 | 2007-04-18 |
| 1164559951 | Anna Marie Lambertson | Preventive Medicine | 824 Solano Cir, Medford, OR 97504 | 2007-02-27 |
| 1104952415 | Vandana H Rana | Preventive Medicine | 17437 Boones Ferry Rd Ste 100, Lake Oswego, OR 97035-6202 | 2007-02-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NORTHWEST LIFESTYLE MEDICINE, INC..
| 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.