Organization
SALEM WELLNESS CLINIC
Active
Parent organization
SALEM WOMEN'S CLINIC, INC.
Other names
Salem Women's Clinic, Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
SALEM WOMEN'S CLINIC, INC.
Authorized official
MR. IBRAHIM ELDESOUKI (CFO)
(503) 399-2444
Entity
Organization
Contact information
Practice address
1395 LIBERTY ST SE, SALEM, OR 97302-4276
(503) 399-2444
(503) 581-3960
Mailing address
1395 LIBERTY ST SE, SALEM, OR 97302-4276
(503) 399-2444
(503) 581-3960
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286300
—
OR
Enumeration date
04/23/2013
Last updated
04/25/2013
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