NPIMap

Organization Active NPI

Willamette Valley Treatment Center

  • Licensed Practical Nurse
  • Salem, OR
National Provider Identifier
1730636762
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201601769LPN Issued in OR
Legal business name
WILLAMETTE VALLEY TREATMENT CENTER
Practice address
3871 Fairview Industrial Dr SE
Salem, OR 97302-1180
Phone
(503) 391-9762
NPI assigned
Sep 7, 2016
Last updated
Sep 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Authorized official

Name
Mr. Jobail Navida LabillesNPI 1689116071
Title
LPN
Phone
(541) 974-1010

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)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X 201601769LPN OR Primary

Addresses

Primary practice location

3871 Fairview Industrial Dr SE
Salem, OR 97302-1180

Mailing address

3513 Silverpark PL NE
Salem, OR 97305-2012
Phone (541) 974-1010

National Provider Directory

National Provider Directory

Locations

3871 Fairview Industrial Dr SE
Salem, OR 97302
Phone (503) 391-9762

Practitioners & affiliated clinicians

Practitioners 11

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": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1730636762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 SILVERPARK PL NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973052012",
            "telephone_number": "541-974-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021180",
            "telephone_number": "503-391-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "LABILLES",
        "authorized_official_first_name": "JOBAIL",
        "authorized_official_middle_name": "NAVIDA",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "541-974-1010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201601769LPN",
            "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 Sep 7, 2016; 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.