| West Salem Clinic Mental Health | |
|
1233 Edgewater St Nw Ste B Salem OR 97304-4049 | |
| (503) 588-5816 | |
| (503) 588-5803 |
| Full Name | West Salem Clinic Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1233 Edgewater St Nw Ste B, Salem, Oregon |
| Authorized Official Name and Position | Paul Logan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5035885831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Salem Clinic Mental Health 681 Center St Ne Salem OR 97301-3722 Ph: (503) 588-5828 | West Salem Clinic Mental Health 1233 Edgewater St Nw Ste B Salem OR 97304-4049 Ph: (503) 588-5816 |
| NPI Number | 1194082867 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 03/13/2023 |
| Medicare PECOS PAC ID | 7012825797 |
|---|---|
| Medicare Enrollment ID | O20120725001026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194082867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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