Wvp Medical Group, LLC
Family Medicine in Salem, OR. Organization (NPI-2).
NPI number1982148789
StatusActive
Last updated in NPPESApr 17, 2018
Details
- NPI
- 1982148789
- Entity type
- Organization (NPI-2)
- Legal business name
- Wvp Medical Group, LLC
- Organization subpart
- Yes
- Enumeration date
- Dec 13, 2016
- Last updated
- Apr 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 208600000X | Surgery | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Wvp The Doctors Clinic (Doing Business As)
Practice location
5050 Skyline Village Loop SSalem, OR 97306-9490
Phone 503-391-1110 · Fax 503-370-4237
Mailing address
2995 Ryan Dr Se Ste 200Salem, OR 97301-5157
Phone 503-371-7701
Authorized official
Dean Andretta
Cfo
5033717701
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