# WILLAMETTE VALLEY ORTHOPAEDIC SURGERY

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

## Provider details

- **NPI number:** 1558571687
- **Authorized official:** DR. PETER K VAN PATTEN MD (DOCTOR)
- **Authorized official phone:** (503) 472-8162

## Contact information

- **Practice address:** 375 SE NORTON LN, SUITE C, MCMINNVILLE, OR 97128-8484
- **Practice address phone:** (503) 472-8162
- **Practice address fax:** (503) 474-9430
- **Mailing address:** 375 SE NORTON LN, SUITE C, MCMINNVILLE, OR 97128-8484
- **Mailing address phone:** (503) 472-8162
- **Mailing address fax:** (503) 474-9430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | MD024130 | OR | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 181583 | — | OR |