# MID VALLEY FAMILY PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MID VALLEY FAMILY PHYSICIANS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225217995
- **Legal business name:** MID VALLEY FAMILY PHYSICIANS
- **Authorized official:** RONALD M PALM DO (PHYSICIAN OWNER)
- **Authorized official phone:** (503) 393-0540

## Contact information

- **Practice address:** 550 DIETZ AVE NE, KEIZER, OR 97303-4615
- **Practice address phone:** (503) 393-0540
- **Practice address fax:** (503) 393-3695
- **Mailing address:** 550 DIETZ AVE NE, KEIZER, OR 97303-4615
- **Mailing address phone:** (503) 393-0540
- **Mailing address fax:** (503) 393-3695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | D025292 | OR | — |
| 207Q00000X | Family Medicine Physician | D025302 | OR | Yes |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 11/01/2007