Organization
H. THOMAS HARVEY
Active
Parent organization
WVP MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
WVP MEDICAL GROUP
Authorized official
MICHELLE ELDRIDGE (CLINIC ADMINISTRATOR)
(503) 362-6304
Entity
Organization
Contact information
Practice address
2995 RYAN DR SE, SUITE 200, SALEM, OR 97301-5157
(503) 371-7701
Mailing address
1155 MISSION ST SE, SUITE 205, SALEM, OR 97302-6228
(503) 362-6304
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD11557
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041947
—
OR
Enumeration date
03/17/2014
Last updated
03/17/2014
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