Provider Demographics
NPI:1104200799
Name:SALAZAR, DEVIN A (NP, CNM)
Entity Type:Individual
Prefix:MRS
First Name:DEVIN
Middle Name:A
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:NP, CNM
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:A
Other - Last Name:SEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071
Mailing Address - Country:US
Mailing Address - Phone:971-983-5260
Mailing Address - Fax:971-983-5326
Practice Address - Street 1:406 WELCH STREET
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-364-3787
Practice Address - Fax:503-763-3595
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201392856RN163W00000X
OR201505393NP-PP176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500690940Medicaid
OR201505393NP-PPOtherOREGON LICENSE