Organization
NEW LIFE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA C BIRD FNP-BC (OWNER/NURSE PRACTITIONER)
(503) 586-8291
Entity
Organization
Contact information
Practice address
842 COMMERCIAL STREET NE, SALEM, OR 97302
(503) 586-8291
Mailing address
PO BOX 5485, SALEM, OR 97304-0485
(503) 586-8291
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
099006422N1
OR
261QP2300X
Primary Care Clinic/Center
099006422RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116907
MEDICARE ID
OR
05
—
210764
—
OR
Enumeration date
09/23/2016
Last updated
01/26/2017
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