OrganizationActive
Countryside Medical LLC
NPI 1467205336 · Primary Care Clinic/Center · Salem, OR
Provider details
- NPI number
- 1467205336
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Natalie Polzen, Fnp-C(503) 930-1854
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2355 State St Ste 101
Salem, OR 97301-4541
Phone: (503) 930-1854
Approximate (ZIP-level) locationGet directions
Mailing address
2355 State St Ste 101
Salem, OR 97301-4541
Registry dates
- Enumerated
- 2024-04-09
- Last updated
- 2024-04-09
- Certified
- 2024-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.