Provider Demographics
NPI:1467677864
Name:CHILDHOOD HEALTH ASSOCIATES OF SALEM
Entity Type:Organization
Organization Name:CHILDHOOD HEALTH ASSOCIATES OF SALEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BEV
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-364-0227
Mailing Address - Street 1:891 23RD ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-364-0227
Mailing Address - Fax:503-364-0364
Practice Address - Street 1:891 23RD ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-364-0227
Practice Address - Fax:503-364-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty