Individual
SAMUEL WILLIAM PACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
960 LIBERTY ST SE STE 200, SALEM, OR 97302-4195
(503) 399-0652
Mailing address
2957 GLEN EAGLES RD, LAKE OSWEGO, OR 97034-2737
(971) 386-8399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA222588
OR
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
06/03/2026
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