NPIMap

Organization Active NPI

Willamette Vascular Specialists, PC

  • Vascular Surgery Physician
  • Salem, OR
National Provider Identifier
1225351901
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD16135 Issued in OR
Legal business name
WILLAMETTE VASCULAR SPECIALISTS, PC
Practice address
1015 25TH St SE
Salem, OR 97301
Phone
(503) 561-7227
Fax
(503) 561-7272
NPI assigned
Mar 9, 2010
Last updated
Mar 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Mark S Peterson, MDNPI 1003980053
Title
Owner
Phone
(503) 561-7227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD16135 OR Primary

Addresses

Primary practice location

1015 25TH St SE
Salem, OR 97301

Mailing address

PO Box 12707
Salem, OR 97309-0707
Phone (503) 561-7227

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1225351901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12707",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973090707",
            "telephone_number": "503-561-7227",
            "fax_number": "503-561-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 25TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-561-7227",
            "fax_number": "503-561-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VASCULAR SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-561-7227",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD16135",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.