Organization
VIDA FAMILY MEDICINE
Active
Other names
Vida Integrative Medicine & Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
TERI LITKE (ADMINISTRATOR)
(503) 399-1400
Entity
Organization
Contact information
Practice address
374 OWENS ST SE, SALEM, OR 97302-4183
(503) 399-1400
(503) 399-1406
Mailing address
PO BOX 883, SALEM, OR 97308-0883
(503) 399-1400
(503) 399-1406
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07-12-12
OR
104100000X
Social Worker
L6901
OR
106H00000X
Marriage & Family Therapist
T0889
OR
106H00000X
Marriage & Family Therapist
T0986
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201402104-NP-PP
OR
Other
Enumeration date
03/28/2016
Last updated
04/11/2022
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