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WVP MEDICAL GROUP LLC NPI 1831504968


NPI Information

NPI: 1831504968
Provider Name: WVP MEDICAL GROUP, LLC

Doing Business As: WVP MEDICAL GROUP- BOULDER CREEK

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
2485 12TH ST. SE
SALEM, OR
ZIP 97302
Phone: (503) 363-8047
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WVP MEDICAL GROUP, LLC is a clinic center in Salem, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). WVP MEDICAL GROUP, LLC NPI is 1831504968. The provider is registered as an organization entity type.
The provider Is Doing Business As Wvp Medical Group- Boulder Creek.

The provider's business location address is:

2485 12TH ST. SE
SALEM, OR
ZIP 97302-000
Phone: (503) 363-8047
Fax: (503) 363-6571

The provider's authorized official is Dean Andretta .
The authorized official title is Cfo and has the following contact phone number (503) 371-7701.

The enumeration date for this NPI number is 6/27/2014 and was last updated on 6/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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