MR. PETER BODMER (NPI# 1639570120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639570120 |
| Entity Type | Individual |
| Full Name | MR. PETER BODMER |
| Credential | PA-C |
| Practice Address |
3896 Beverly Ave Ne Salem OR 97305-1374 |
| Mailing Address |
601 N Keys Rd Yakima WA 98901-1172 |
| Practice Telephone | 5035880076 |
| Practice Fax Number | 5035880531 |
| Mailing Telephone | 5098652395 |
| Mailing Fax Number | 5098650757 |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2015-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA174107 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3896 BEVERLY AVE NE |
| City | SALEM |
| State | OR |
| Zip Code | 97305-1374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760431464 | Jenny L Stegeman-olsen | Family Medicine | 3896 Beverly Ave Ne, Bldg J, Suite 40, Salem, OR 97305-1374 | 2006-05-09 |
| 1912358730 | Susannah Martell | Registered Nurse | 3896 Beverly Ave Ne, Bldg J, Suite 40, Salem, OR 97305-1374 | 2016-06-22 |
| 1043668940 | Erin Elizabeth Steiner | Nurse Practitioner | 3896 Beverly Ave Ne, Bldg J, Suite 40, Salem, OR 97305-1374 | 2016-06-01 |
| 1306275847 | Laura White | Counselor | 3896 Beverly Ave Ne, Building J, Suite 40, Salem, OR 97305-1374 | 2013-11-05 |
| 1093056053 | Lauren Truxillo | Physician Assistant | 3896 Beverly Ave Ne, Bldg J, Suite 40, Salem, OR 97305-1374 | 2013-03-14 |
| 1376847012 | Vanessa B Lind | Physician Assistant | 3896 Beverly Ave Ne, Building J, Ste. 40, Salem, OR 97305-1374 | 2011-01-10 |
| 1992021745 | Leslie A Drapiza | Family Medicine | 3896 Beverly Ave Ne, Building J, Ste, Salem, OR 97305-1374 | 2010-04-19 |
| 1417273426 | Kathy Tran Shaw | Family Medicine | 3896 Beverly Ave Ne, Bldg J, Suite 40, Salem, OR 97305-1374 | 2010-04-15 |
| 1750538310 | Skye Gustin Waggoner | Physician Assistant | 3896 Beverly Ave Ne, Bldg J, Ste 40, Salem, OR 97305-1374 | 2008-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
| 1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
| 1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
| 1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
| 1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
| 1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
| 1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
| 1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
| Find all providers in zip 97305 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374660 | Sarah Ilana Katz | Physician Assistant | 11a Laurel St, Salem, MA 01970-4657 | 2020-10-21 |
| 1306444641 | Zachary Wright | Physician Assistant | 11 Harley Ln, Salem, NH 03079-2888 | 2020-10-09 |
| 1174132195 | Andrew Yosim | Physician Assistant | 1750 Pexton Ave, Salem, VA 24153-4108 | 2020-07-27 |
| 1689202269 | Adam Joyce | Physician Assistant | 1005 Meadowrun Ct, Salem, VA 24153-6687 | 2020-03-30 |
| 1417504085 | Alexis Marie Biewend | Physician Assistant | 1645 Waln Dr Se Apt 263, Salem, OR 97306-2963 | 2019-08-19 |
| 1497309322 | Lindsey Ann Castleberry | Physician Assistant | 1111 Meadow Sage Cir, Salem, UT 84653-5578 | 2019-07-29 |
| 1134773450 | Jillian Netland | Physician Assistant | 6507 Lipscomb St Se, Salem, OR 97317-9513 | 2019-07-25 |
| 1457827354 | Gretchen Amrien | Physician Assistant | 4 Bypass Rd Ste 201, Salem, NJ 08079-2053 | 2018-10-17 |
| 1649751934 | Matthew Hansen | Physician Assistant | 875 Oak St. Se Ste 5020, Salem, OR 97301 | 2018-08-24 |
| 1487152948 | Jessica Lynn Brooks | Physician Assistant | 875 Oak St Se Ste 5060, Salem, OR 97301 | 2018-01-30 |
| 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.