| West Salem Vision Center | |
|
1594 Edgewater St Nw Ste 190 Salem OR 97304-4656 | |
| (503) 779-2119 | |
| Not Available |
| Full Name | West Salem Vision Center |
|---|---|
| Speciality | Clinic/center |
| Location | 1594 Edgewater St Nw Ste 190, Salem, Oregon |
| Authorized Official Name and Position | Alton Stacy Rossman (OWNER) |
| Authorized Official Contact | 5037792119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Salem Vision Center 1594 Edgewater St Nw Ste 190 Salem OR 97304-4656 Ph: (503) 779-2119 | West Salem Vision Center 1594 Edgewater St Nw Ste 190 Salem OR 97304-4656 Ph: (503) 779-2119 |
| NPI Number | 1881840882 |
|---|---|
| Provider Enumeration Date | 08/11/2008 |
| Last Update Date | 08/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881840882 | NPI | - | NPPES |
| 230911 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2855ATI (Oregon) | Primary |
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