Organization
WVP MEDICAL GROUP, LLC
Active
Parent organization
MID VALLEY IPA (WVP HEALTH AUTHORITY)
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID VALLEY IPA (WVP HEALTH AUTHORITY)
Authorized official
MR. DEAN ANDRETTA (CFO)
(503) 371-7701
Entity
Organization
Contact information
Practice address
5100 RIVER RD N, KEIZER, OR 97303-5371
(503) 393-2533
(503) 393-5978
Mailing address
2995 RYAN DR SE STE 200, SALEM, OR 97301-5157
(503) 371-7701
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288533
—
OR
Enumeration date
12/13/2010
Last updated
04/17/2018
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