Active NPI
Salem Womens Clinic, Inc
- Primary Care Nurse Practitioner
- Salem, OR
National Provider Identifier
1801230776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- SALEM WOMENS CLINIC, INC
- Doing business as
- Salem Women's Clinic, Inc
- Practice address
- 1395 Liberty St SE
Salem, OR 97302-4276 - Phone
- (503) 399-2444
- Fax
- (503) 581-3960
- NPI assigned
- Apr 23, 2013
- Organization subpart
- Yes
- Parent organization
- SALEM WOMEN'S CLINIC, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ibrahim Eldesouko
- Title
- Office Manager
- Phone
- (503) 399-2444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
1395 Liberty St SE
Salem, OR 97302-4276
Mailing address
1395 Liberty St SE
Salem, OR 97302-4276
Phone (503) 399-2444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286300 | Medicaid | OR |
Other names 1
- Salem Women's Clinic, Inc
National Provider Directory
National Provider Directory- Tax ID family
- Salem Womens Clinic
- Part of
- Salem Womens Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Obstetrics & Gynecology Physician
- Salem, OR
- NPI 1760415202
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Salem, OR
- NPI 1487688396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780012800000",
"number": "1801230776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1395 LIBERTY ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973024276",
"telephone_number": "503-399-2444",
"fax_number": "503-581-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1395 LIBERTY ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973024276",
"telephone_number": "503-399-2444",
"fax_number": "503-581-3960"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SALEM WOMENS CLINIC, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SALEM WOMEN'S CLINIC, INC.",
"enumeration_date": "2013-04-23",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A",
"authorized_official_last_name": "ELDESOUKO",
"authorized_official_first_name": "IBRAHIM",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "503-399-2444"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286300",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Salem Women's Clinic, Inc",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salem, OR
- Salem Travel Clinic, LLC (Salem Travel Clinic)
- Salem Vascular Consultants, LLP
- Salem Vascular, PC (Salem Vein & Aesthetics Center)
- Salem West of Cascadia, LLC
- Salem Womens Clinic, Inc
- Salemtowne Dental LLC
- Laura Esther Salgado
- Amanda Christine Salmick, LCSW
- Sonny Saltalamachia, LPC
- Leanna Marie Saltarello
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.