Organization
NORTHWEST LIFESTYLE MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS A BRAMAN MD, MPH (PRESIDENT)
(971) 983-5433
Entity
Organization
Contact information
Practice address
6250 COMMERCIAL ST SE, SUITE 100, SALEM, OR 97306-1333
(971) 983-5433
(971) 983-5434
Mailing address
PO BOX 4141, SALEM, OR 97302-8141
(971) 983-5433
(971) 983-5434
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
MD21630
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500656754
—
OR
Enumeration date
08/03/2009
Last updated
12/29/2015
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