SALEM WELLNESS CLINIC (NPI# 1801230776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801230776 |
Entity Type | Organization |
Organization Name | SALEM WELLNESS CLINIC |
Other Organization Name | SALEM WOMEN'S CLINIC, INC |
Practice Address |
1395 Liberty St Se Salem OR 97302-4276 |
Practice Telephone | 5033992444 |
Practice Fax Number | 5035813960 |
Mailing Telephone | 5033992444 |
Mailing Fax Number | 5035813960 |
Enumeration Date | 2013-04-23 |
Last Update Date | 2013-04-25 |
Authorized Official Name | MR. IBRAHIM ELDESOUKI (CFO) |
Authorized Official Telephone | 5033992444 |
Is Organization Subpart | Y |
Parent Organization Name | SALEM WOMEN'S CLINIC, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 286300 | 05 |
Other Name | Type Code |
---|---|
Salem Women's Clinic, Inc | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | SALEM WELLNESS CLINIC | 1395 Liberty St Se, Salem, OR 97302 |
Street Address |
1395 LIBERTY ST SE |
City | SALEM |
State | OR |
Zip Code | 97302-4276 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760415202 | Salem Womens Clinic, Inc | Nurse Practitioner | 1395 Liberty St Se, Salem, OR 97302-4276 | 2006-07-08 |
1134616022 | Brms LLC | Naturopath | 1395 Liberty St Se, Salem, OR 97302-4276 | 2018-04-17 |
1114292034 | Deborah M Johnson Md PC | Clinic/Center | 1395 Liberty St Se, Salem, OR 97302-4276 | 2012-03-09 |
1194911032 | Donna Jean Niemela | Nurse Practitioner | 1395 Liberty St Se, Salem, OR 97302-4276 | 2007-09-24 |
1053494294 | Deborah M Johnson | Obstetrics & Gynecology | 1395 Liberty St Se, Salem, OR 97302-4276 | 2006-10-23 |
1881618163 | Mary L. Henderson | Nurse Practitioner | 1395 Liberty St Se, Salem, OR 97302-4273 | 2006-07-27 |
1316971955 | Patricia M. Mcbride | Nurse Practitioner | 1395 Liberty St Se, Salem, OR 97302-4273 | 2006-07-10 |
1487688396 | Elizebeth R. Harmon | Obstetrics & Gynecology | 1395 Liberty St Se, Salem, OR 97302-4276 | 2006-07-10 |
1588698187 | Katherine Ellen S. Davidson | Nurse Practitioner | 1395 Liberty St Se, Salem, OR 97302-4276 | 2006-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
Find all providers in zip 97302 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578112025 | Dorothy Lee Jordan | Nurse Practitioner | 10a Loren Rd, Salem, NH 03079-3127 | 2019-09-07 |
1508484528 | Lisa M Harrison | Nurse Practitioner | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2020-07-07 |
1982154142 | Francesca Anna Carmone | Nurse Practitioner | 400 Highland Ave, Salem, MA 01970-7003 | 2016-10-11 |
1720537814 | Bradley K Busey II | Nurse Practitioner | 1095 Liberty St Ne, Salem, OR 97301-1137 | 2016-09-29 |
1518320555 | Complete Care of South Jersey | Nurse Practitioner | 310 Route 45, Salem, NJ 08079-2064 | 2016-03-29 |
1215305982 | Evercare Medical Associates | Nurse Practitioner | 59 Stiles Rd, Suite 104, Salem, NH 03079-2885 | 2015-09-10 |
1902822661 | Deborah B Dutton | Nurse Practitioner | 141 Hospital Dr, Salem, KY 42078-8043 | 2006-07-14 |
1790741668 | Martha Emily Lacy | Nurse Practitioner | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2006-04-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154956233 | Ellen Faye Barlow | Nurse Practitioner | 506 Fourth St., La Grande, OR 97850 | 2020-03-09 |
1225698889 | Agewell Geriatrics, LLC | Nurse Practitioner | 13120 Sw Heather Ct, Beaverton, OR 97008-5612 | 2019-06-17 |
1760960462 | Sid Christian Keomanivong | Nurse Practitioner | 2677 Beall Ln, Central Point, OR 97502-1462 | 2018-08-03 |
1245611771 | Karen Musick | Nurse Practitioner | 3514 Nw Mckinley Dr, Corvallis, OR 97330-1148 | 2015-06-10 |
1184054546 | Nancy M Burgess Rn Msn Anp-c PC | Nurse Practitioner | 910 Sw Highway 97 Ste 104, Madras, OR 97741-9247 | 2013-11-22 |
1518391804 | Sally Elizabeth Kraynik | Nurse Practitioner | 1895 E Main St, Hillsboro, OR 97123-4345 | 2013-08-22 |
1295998920 | Paula Jo Cramer | Nurse Practitioner | 790 S Main St Myrtle, Creek, Ore, Myrtle Creek, OR 97457 | 2008-07-02 |
1780855601 | Leslie West | Nurse Practitioner | 51730 Dexter St., Blue River, OR 97413-0183 | 2008-03-19 |
1548399322 | Corporate Health Nw | Nurse Practitioner | 10209 Se Division St, Portland, OR 97266-1327 | 2007-03-05 |
1962540310 | Laura Ann Shattuck | Nurse Practitioner | 21440 S Upper Highland Rd, Beavercreek, OR 97004-8814 | 2007-02-01 |
Find all providers with the same taxonomy |
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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.