Organization
PRIMARY CARE WEST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI LEANNE HOVENDEN (OFFICE MANAGER)
(503) 362-1314
Entity
Organization
Contact information
Practice address
1255 WALLACE RD NW, SALEM, OR 97304-3007
(503) 362-1314
Mailing address
1255 WALLACE RD NW, SALEM, OR 97304-3007
(503) 362-1314
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
13749
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019179
—
OR
05
—
021159
—
OR
05
—
278804
—
OR
Enumeration date
07/13/2005
Last updated
10/21/2020
Update your record
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