Organization
WVP MEDICAL GROUP, LLC
Active
Parent organization
MID VALLEY IPA, INC
Other names
WVP Medical Group- Boulder Creek
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID VALLEY IPA, INC
Authorized official
MR. DEAN ANDRETTA (CFO)
(503) 371-7701
Entity
Organization
Contact information
Practice address
2485 12TH ST. SE, SALEM, OR 97302-0000
(503) 363-8047
(503) 363-6571
Mailing address
2485 12TH ST. SE, SALEM, OR 97302-0000
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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