Organization
WILLAMETTE VASCULAR SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S PETERSON MD (OWNER)
(503) 561-7227
Entity
Organization
Contact information
Practice address
1015 25TH ST SE, SALEM, OR 97301
(503) 561-7227
(503) 561-7272
Mailing address
PO BOX 12707, SALEM, OR 97309-0707
(503) 561-7227
(503) 561-7272
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD16135
OR
Other
Enumeration date
03/09/2010
Last updated
03/08/2011
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