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1233 Edgewater St Nw Salem OR 97304-4049 | |
| (503) 378-7526 | |
| (503) 480-1630 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1233 Edgewater St Nw, 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 |
|---|---|
681 Center St Ne Salem OR 97301-3722 Ph: (503) 588-5828 | 1233 Edgewater St Nw Salem OR 97304-4049 Ph: (503) 378-7526 |
| NPI Number | 1871530758 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 03/13/2023 |
| Medicare PECOS PAC ID | 7012825797 |
|---|---|
| Medicare Enrollment ID | O20040302000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871530758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Angela L Maldonado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508921214 PECOS PAC ID: 9234230434 Enrollment ID: I20070718000217 |
| Provider Name | Zoltan Teglassy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497951909 PECOS PAC ID: 4981767860 Enrollment ID: I20090121000093 |
| Provider Name | Timothy L Truschel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164541439 PECOS PAC ID: 4688768260 Enrollment ID: I20121112000533 |
| Provider Name | Joshua F Sandeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699050492 PECOS PAC ID: 3971762287 Enrollment ID: I20130423000134 |
| Provider Name | Eric Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568751741 PECOS PAC ID: 1355596149 Enrollment ID: I20140829000153 |
| Provider Name | Beth Ellen Erickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184146417 PECOS PAC ID: 1557628377 Enrollment ID: I20171204002847 |
| Provider Name | Marc R Malone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992273718 PECOS PAC ID: 2567701741 Enrollment ID: I20190306000361 |
| Provider Name | Sharon Voss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568914497 PECOS PAC ID: 9133462070 Enrollment ID: I20190516002750 |
| Provider Name | Elisabeth Ruth Decelles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114435807 PECOS PAC ID: 0345501029 Enrollment ID: I20190819003089 |
| Provider Name | Caitlin Sierra Maclaurin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912340969 PECOS PAC ID: 4587992607 Enrollment ID: I20190827001780 |
| Provider Name | Maria Niemuth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538546668 PECOS PAC ID: 3678831211 Enrollment ID: I20201013003213 |
| Provider Name | Jennifer L Starck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689991226 PECOS PAC ID: 5395153845 Enrollment ID: I20210421002067 |
| Provider Name | Paige F Tomes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053847442 PECOS PAC ID: 8022362177 Enrollment ID: I20211025002718 |
| Provider Name | Brianna Sexton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407319874 PECOS PAC ID: 6305212291 Enrollment ID: I20230119003300 |
| Provider Name | Claire Alvarenga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336722081 PECOS PAC ID: 8820446347 Enrollment ID: I20231122000612 |
| Provider Name | Tonya M Griffin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245496231 PECOS PAC ID: 1355791351 Enrollment ID: I20240102003761 |
| Provider Name | Jazmin Haun |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922887926 PECOS PAC ID: 7113378670 Enrollment ID: I20240109002273 |
| Provider Name | Lior Azen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467640847 PECOS PAC ID: 7214370295 Enrollment ID: I20240206004681 |
| Provider Name | Heather Kathleen Moon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821261199 PECOS PAC ID: 4981871019 Enrollment ID: I20240926000739 |
| Provider Name | Lisa Leiann Warmington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821815408 PECOS PAC ID: 3072048008 Enrollment ID: I20241127000656 |
| Provider Name | Lauren Michelle Teague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104509900 PECOS PAC ID: 5294261012 Enrollment ID: I20241203004733 |
| Provider Name | Nicholas Jordan Adair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912521816 PECOS PAC ID: 7719413459 Enrollment ID: I20241205000814 |
Life Balance Acupuncture Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 Liberty St Ne, Salem, OR 97301 Phone: 503-881-8996 | |
Alante Primary Care O Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 20th St Se Ste 310, Salem, OR 97302 Phone: 480-631-4978 Fax: 844-443-4378 | |
West Salem Family Practice Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1275 Wallace Rd Nw, Salem, OR 97304 Phone: 503-371-3232 Fax: 503-375-2398 | |
Salem Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 Bellevue St Se, Salem, OR 97301 Phone: 503-814-5554 | |
New Focus Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5560 Witzel Rd Se, Salem, OR 97317 Phone: 503-581-8251 Fax: 503-363-8543 | |
Santiam Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Deer Park Dr Se, Salem, OR 97317 Phone: 503-589-8101 | |
Alante Health - Oregon Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1220 20th St Se Ste 310, Salem, OR 97302 Phone: 480-631-4978 |