Organization
SALEM CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA GUNDER (ADMINISTRATOR/CAO)
(503) 399-2470
Entity
Organization
Contact information
Practice address
1165 UNION ST NE, SALEM, OR 97301-4693
(503) 399-2424
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179051
—
OR
01
—
CS4159
RAILROAD MEDICARE GROUP NO.
OR
Enumeration date
02/15/2008
Last updated
12/06/2016
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