# VIDA FAMILY MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vida Integrative Medicine & Mental Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063567832
- **Authorized official:** TERI L LITKE-FETSCH (ADMINISTRATOR)
- **Authorized official phone:** (503) 399-1400

## Contact information

- **Practice address:** 374 OWENS ST SE STE 100, SALEM, OR 97302-4183
- **Practice address phone:** (503) 399-1400
- **Practice address fax:** (503) 399-1406
- **Mailing address:** PO BOX 883, SALEM, OR 97308-0883
- **Mailing address phone:** (503) 399-1400
- **Mailing address fax:** (503) 399-1406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 04/11/2022