Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | NB26000 | OR |
NPI | 1003989781 |
---|---|
Provider Name | Andrew C Westfall |
First Address | Salem, OR 97302 |
Second Address | Salem, OR 97302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048239003 | OREGON BLUE CROSS (01) | |
213738 | (05) | OR |
I34820 | (02) |