Active NPI
Pacific Family Medical Center LLC
- Family Medicine Physician
- Salem, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD22310
- Legal business name
- PACIFIC FAMILY MEDICAL CENTER LLC
- Practice address
- 1285 Liberty St SE
Salem, OR 97302-4243 - Phone
- (503) 540-7477
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle A Rasmussen, MD
- Title
- Owner
- Phone
- (503) 540-7477
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD22310 | OR | Primary |
Addresses
Primary practice location
1285 Liberty St SE
Salem, OR 97302-4243
Mailing address
1285 Liberty St SE
PO Box 31
Salem, OR 97302-4243
Phone (503) 540-7477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114653 | Medicaid | OR |
National Provider Directory
National Provider Directory- Tax ID family
- Pacific Family Medical Center LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Salem, OR
- NPI 1831264357
Locations
1285 Liberty St SE
Salem, OR 97302
Phone (503) 540-7477
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Salem, OR
- NPI 1417961954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1366515736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1285 LIBERTY ST SE",
"address_2": "PO BOX 31",
"city": "SALEM",
"state": "OR",
"postal_code": "973024243",
"telephone_number": "503-540-7477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1285 LIBERTY ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973024243",
"telephone_number": "503-540-7477"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC FAMILY MEDICAL CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "RASMUSSEN",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-540-7477",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OR",
"license": "MD22310",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114653",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.