# PDH FAMILY MEDICAL HOME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518285915
- **Authorized official:** DR. PHYLLIS D HURSEY MD FAAFP (OWNER)
- **Authorized official phone:** (503) 399-7474

## Contact information

- **Practice address:** 608 LANCASTER DR SE, SALEM, OR 97317-5643
- **Practice address phone:** (503) 399-7474
- **Practice address fax:** (503) 399-0679
- **Mailing address:** 581 LANCASTER DR SE \# 288, SALEM, OR 97317-5642
- **Mailing address phone:** (503) 399-7474
- **Mailing address fax:** (503) 399-0679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD26240 | OR | Yes |

## Other

- **Enumeration date:** 05/10/2010
- **Last updated:** 05/10/2010