| Compassion Care Family Practice Llc | |
|
1025 2nd St Nw Salem OR 97304-4001 | |
| (503) 559-3312 | |
| Not Available |
| Full Name | Compassion Care Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1025 2nd St Nw, Salem, Oregon |
| Authorized Official Name and Position | Marci Lyn Cogdill (OWNER) |
| Authorized Official Contact | 5035593312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassion Care Family Practice Llc 801 Rumsey Ct Nw Salem OR 97304-3792 Ph: (503) 559-3312 | Compassion Care Family Practice Llc 1025 2nd St Nw Salem OR 97304-4001 Ph: (503) 559-3312 |
| NPI Number | 1386280220 |
|---|---|
| Provider Enumeration Date | 11/26/2019 |
| Last Update Date | 11/26/2019 |
| Medicare PECOS PAC ID | 8729415765 |
|---|---|
| Medicare Enrollment ID | O20200303002193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386280220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marci L Cogdill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518362235 PECOS PAC ID: 4981927464 Enrollment ID: I20150109000008 |
| Provider Name | Kerrie E Spicer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063855864 PECOS PAC ID: 1355646035 Enrollment ID: I20160217000879 |
| Provider Name | Penelope Elizabeth Lutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679228431 PECOS PAC ID: 8123414000 Enrollment ID: I20220331002561 |
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