Organization Active NPI

West Salem Family Practice Associates LLC

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1003817826
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEST SALEM FAMILY PRACTICE ASSOCIATES LLC
Practice address
1275 Wallace Rd NW
Salem, OR 97304-3007
Phone
(503) 371-3232
Fax
(503) 375-2398
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark Lee Tinseth
Title
Administrator
Phone
(503) 763-6006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OR Primary

Addresses

Primary practice location

1275 Wallace Rd NW
Salem, OR 97304-3007

Mailing address

1275 Wallace Rd NW
Salem, OR 97304-3007
Phone (503) 371-3232

Other identifiers 1

IdentifierTypeStateIssuer
286761MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001557 OR Part B Supplier - Clinic/Group Practice 7113911504 Receives reassigned benefits from 10 practitioners
Practice locations: Salem, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0625782West Salem Family Practice Associates1275 Wallace Rd NW, Salem, OR 97304Provider-performed microscopyDec 31, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1003817826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043007",
            "telephone_number": "503-371-3232",
            "fax_number": "503-375-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043007",
            "telephone_number": "503-371-3232",
            "fax_number": "503-375-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SALEM FAMILY PRACTICE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "TINSETH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-763-6006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286761",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.