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VIDA FAMILY MEDICINE LLC NPI 1063567832


NPI Information

NPI: 1063567832
Provider Name: VIDA FAMILY MEDICINE, LLC

Doing Business As: VIDA INTEGRATIVE MEDICINE & MENTAL HEALTH

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 38D1045258

Address:
374 OWENS ST SE STE 100
SALEM, OR
ZIP 97302
Phone: (503) 399-1400
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VIDA FAMILY MEDICINE, LLC is a family medicine in Salem, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. VIDA FAMILY MEDICINE, LLC NPI is 1063567832. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Vida Integrative Medicine & Mental Health.

The provider's business location address is:

374 OWENS ST SE STE 100
SALEM, OR
ZIP 97302-183
Phone: (503) 399-1400
Fax: (503) 399-1406

The provider's authorized official is Teri L Litke-fetsch .
The authorized official title is Administrator and has the following contact phone number (503) 399-1400.

The CLIA number assigned to this NPI record is 38D1045258 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/24/2007 and was last updated on 4/11/2022.


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
1207Q00000XFamily MedicineYes

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: 4/28/2024

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