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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
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