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CAROLYN S FAIRFAX MD
NPI 1407839384
Family Medicine in Grand Ronde, OR

Active since November 23, 2005
9605 GRAND RONDE RD, GRAND RONDE, OR 97347(503) 879-2002(503) 879-2071 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Carolyn S Fairfax Md NPPES

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

CAROLYN S FAIRFAX MD (NPI 1407839384) is an individual family medicine provider in Grand Ronde, Oregon, licensed in Oregon (MD16107) and active in the NPI registry since November 2005. She maintains a secondary practice location in Salem.

NPPES Registry Identity

NPI1407839384
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCAROLYN S FAIRFAXCredential: MD
Location Address9605 GRAND RONDE RDGrand Ronde, OR 97347-9712
Mailing Address9605 Grand Ronde RdGrand Ronde, OR 97347-9712 · (503) 879-2002 · Fax (503) 370-4237
Phone(503) 879-2002
Fax(503) 879-2071
Sole ProprietorNo
Enumeration DateNovember 23, 2005
Last NPPES UpdateJune 7, 2021
NPPES CertifiedJune 7, 2021
✔ NPI 1407839384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · MD16107
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9605 GRAND RONDE RD, Grand Ronde, OR 97347
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Secondary Practice Location 1

Location 15050 Skyline Village Loop SSalem, OR 97306-9490 · Phone (503) 391-1110 · Fax (503) 370-4237

Other Identifiers 1

Medicaid076393OR

Other Providers at the Same Location NPPES 20

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

HEIDI KATHLEEN HICINBOTHOM
Peer Specialist
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2026
STEPHANIE KING CHW
Community Health Worker
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2078
NATASHA RAE WORDEN PEER SUPPORT
Peer Specialist
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2297
MS. KARAN ELAINE SCHARF CDCIII
Counselor (Addiction (Substance Use Disorder))
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2236
HEATHER MANKA DMD
Dentist
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2020
DR. ERIN MARGARET LANGE DMD
Dentist
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2020
MR. MAURICE A AJAIFIA PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2026
CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON DBA GR HEALTH &
Clinic/Center (Community Health)
9605 GRAND RONDE RD
GRAND RONDE, OR 97347
Polk County (503) 879-2236

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 Carolyn Fairfax's NPI number?

The NPI number for Carolyn Fairfax is 1407839384. It was assigned to this individual provider in the NPPES registry on November 23, 2005.

Where is Carolyn Fairfax located?

Carolyn Fairfax practices at 9605 Grand Ronde Rd, Grand Ronde, OR 97347. The listed phone number is (503) 879-2002.

What is Carolyn Fairfax's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Carolyn Fairfax was last updated on June 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.