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ADVANCED VASCULAR THERAPY LLC
NPI 1356726418
Surgery - Vascular Surgery in Salem, OR

Active since July 29, 2015
2480 LIBERTY ST NE, SUITE 110, SALEM, OR 97301(503) 371-1756 Get Directions Write a Review

NPPES record last updated: November 20, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Advanced Vascular Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED VASCULAR THERAPY LLC (NPI 1356726418) is a healthcare organization registered as a vascular surgery in Salem, Oregon and active in the NPI registry since July 2015. The organization lists Glen S Roseborough, Director, as its authorized official.

NPPES Registry Identity

NPI1356726418
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameADVANCED VASCULAR THERAPY LLC
Location Address2480 LIBERTY ST NE, SUITE 110Salem, OR 97301-8380
Mailing Address2480 Liberty St Ne, Suite 110Salem, OR 97301-8380 · (503) 371-1756
Phone(503) 371-1756
Organization SubpartNo
Authorized OfficialGlen S RoseboroughDirector · (503) 371-1756
Enumeration DateJuly 29, 2015
Last NPPES UpdateNovember 20, 2015
✔ NPI 1356726418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
License✔ Licensed in OR · MD150190
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
2480 LIBERTY ST NE, Salem, OR 97301
Open in Google Maps ↗

Other Identifiers 2

Medicaid599512556OR
Medicare UPINH25149OR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAIN CARE SPECIALISTS, PC
Anesthesiology (Pain Medicine)
2480 LIBERTY ST NE, SUITE 180
SALEM, OR 97301
Marion County (503) 371-1010
DR. POLY CHEN M.D.
Pain Medicine (Interventional Pain Medicine)
2480 LIBERTY ST NE, SUITE 110
SALEM, OR 97301
Marion County (503) 371-1010
JANELLE ZYCH DPT
Physical Therapist
2480 LIBERTY ST NE, SUITE 140
SALEM, OR 97301
Marion County (503) 763-3525
GLEN STANLEY ROSEBOROUGH MD
Surgery (Vascular Surgery)
2480 LIBERTY ST NE, SUITE 110
SALEM, OR 97301
Marion County (503) 371-1756
DR. WALLACE I LAI I MD
Internal Medicine (Clinical Cardiac Electrophysiology)
2480 LIBERTY ST NE, SUITE 110
SALEM, OR 97301
Marion County (503) 371-1756
WILLAMETTE OPEN IMAGING, LLC
Clinic/Center (Radiology)
2480 LIBERTY ST NE, STE. 110
SALEM, OR 97301
Marion County (503) 581-2021
NASH WILLIAM KEENE STUDENT
Physician Assistant (Medical)
2480 LIBERTY ST NE, SUITE 180
SALEM, OR 97301
Marion County (503) 371-1010
ALYCE M. HUNTSINGER FNP, NNP
Nurse Practitioner (Family)
2480 LIBERTY ST NE, SUITE 180
SALEM, OR 97301
Marion County (503) 363-8047

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Vascular Therapy LLC's NPI number?

The NPI number for Advanced Vascular Therapy LLC is 1356726418. It was assigned to this organization in the NPPES registry on July 29, 2015.

Where is Advanced Vascular Therapy LLC located?

Advanced Vascular Therapy LLC is located at 2480 Liberty St NE Suite 110, Salem, OR 97301. The listed phone number is (503) 371-1756.

What is Advanced Vascular Therapy LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

When was this NPI record last updated?

The NPPES record for Advanced Vascular Therapy LLC was last updated on November 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.