| Pacific Family Medical Center Llc | |
|
1285 Liberty St Se Salem OR 97302-4243 | |
| (503) 540-7477 | |
| Not Available |
| Full Name | Pacific Family Medical Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1285 Liberty St Se, Salem, Oregon |
| Authorized Official Name and Position | Michelle A Rasmussen (OWNER) |
| Authorized Official Contact | 5035407477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Family Medical Center Llc 1285 Liberty St Se Po Box 31 Salem OR 97302-4243 Ph: (503) 540-7477 | Pacific Family Medical Center Llc 1285 Liberty St Se Salem OR 97302-4243 Ph: (503) 540-7477 |
| NPI Number | 1366515736 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366515736 | NPI | - | NPPES |
| 114653 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD22310 (Oregon) | Primary |
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