Salem Pediatric Clinic
Organization Active NPI Pediatrics Physician · Salem, OR
NPI 1245307693 · NPPES record last updated Mar 4, 2015
Key facts
- NPI
- 1245307693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- SALEM PEDIATRIC CLINIC
- Practice address
- 2478 13TH St SE
Salem, OR 97302-2546 - Phone
- (503) 362-2481
- Fax
- (503) 371-7803
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Liz Casebeer
- Title
- Administrator
- Phone
- (503) 485-3707
Practitioners 6
-
Matthew Hatler, M.D.
-
Rachael Hiebert, M.D.
-
Thu Bao Trung Vu, M.D.
-
Karissa E Carstensen, M.D.
-
Ian Straehley, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0667311 | Salem Pediatric Clinic | Certificate of waiver | Dec 31, 2026 |
National Provider Directory
Locations
2478 13th St SE
Salem, OR 97302
Phone (503) 362-2481
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
2478 13TH St SE
Salem, OR 97302-2546
Mailing address
2478 13TH St SE
Salem, OR 97302-2546
Phone (503) 362-2481
Other providers in Salem, OR
- Salem of Olympus, LLC
- Salem Or Ophthalmology ASC LLC
- Salem Oregon Counseling LLC
- Salem Pain and Spine Specialists PC
- Salem Pastoral Counseling Center
- Salem Physical Therapy
- Salem Psychiatric Associates PC
- Salem Psychiatric Associates, P.C.
- Salem Psychiatry & Wellness LLC
- Salem Psychological Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.