Organization Active NPI

Salem Womens Clinic, Inc

  • Primary Care Nurse Practitioner
  • Salem, OR
National Provider Identifier
1801230776
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
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.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2026

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)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
286300MedicaidOR

Other names 1

  • Salem Women's Clinic, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Salem Womens Clinic2 organizations share this tax ID, including this one
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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

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.

Verify at the official NPI Registry.