Pain Management Northwest, Inc

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

PAIN MANAGEMENT NORTHWEST, INC

Practice address

350 Miller St SE # 100
Salem, OR 97302

Phone

(503) 371-4647

Fax

(503) 584-7856

NPI assigned

May 29, 2007

Last updated

Jan 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig D Anderson, M.D.NPI 1629014824

Title

President

Phone

(503) 371-4647

Specialties & licenses 2

Addresses

Locations

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.

• Craig Douglas Anderson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Salem, OR
  • NPI 1629014824
  NPD (past) Authorized official

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1619178662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MILLER ST SE # 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024272",
            "telephone_number": "503-371-4647",
            "fax_number": "503-584-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MILLER ST SE # 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-4647",
            "fax_number": "503-584-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4999 Skyline Rd S # 100",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973062009",
            "country_code": "US",
            "telephone_number": "503-371-4647",
            "fax_number": "503-485-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN MANAGEMENT NORTHWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-371-4647",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "088393-91",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel William Packham, PA-C
• Victoria R Padron, RD, LD, CD
• Michelle Lyn Pagel, B.S
• Pain Care Specialists of Oregon, LLC
• Pain Care Specialists, PC
• Pain Solutions Physical Therapy LLC
• Gina Michele Paine, PHYSICAL THERAPIST
• Thomas Rado Palandech, DDS
• Nadine Smith Palmateer, MA
• Derek Lee Palmer, DPT

• Interventional Pain Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Interventional Pain Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.