Maurice Collada Jr. MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD13614 Issued in OR

Legal business name

MAURICE COLLADA JR. MD PC

Practice address

1344 Liberty St SE
Salem, OR 97302-4283

Phone

(503) 581-5517

Fax

(503) 581-6341

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Khristy Spaeth

Title

Office Manager

Phone

(503) 581-5517

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1285813071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024283",
            "telephone_number": "503-581-5517",
            "fax_number": "503-581-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024283",
            "telephone_number": "503-581-5517",
            "fax_number": "503-581-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICE COLLADA JR. MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "SPAETH",
        "authorized_official_first_name": "KHRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-581-5517"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD13614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "103728",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gennaya Lynn Mattison, M.D.
• Edward Mattson, PHARM. D.
• Teena Matuska, PTA
• Daniel Wayne Maurer Jr.
• Heather Maurer, CADC-R
• Laura Maurillo
• Amity Beth Haddon Maxwell, MSW, LCSW
• Arnita Elaine Maxwell, LMT
• Ericka Maxwell
• Kimberly Maxwell

• Specialist in Salem, OR
• Providers in Salem, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.