OrganizationActive
Advanced Vascular Therapy LLC
NPI 1356726418 · Vascular Surgery Physician · Salem, OR
Provider details
- NPI number
- 1356726418
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Glen Roseborough, Director
- License
- MD150190 (OR)
Practice location
2480 Liberty St Ne
Suite 110
Salem, OR 97301-8380
Phone: (503) 371-1756
Mailing address
2480 Liberty St Ne
Salem, OR 97301-8380
Registry dates
- Enumerated
- 2015-07-29
- Last updated
- 2015-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.