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PACIFIC COAST CLINIC SALEM LLC
NPI 1669704805
Clinic/Center - Adult Mental Health in Salem, OR

Active since February 11, 2010
1249 FAIRVIEW AVE SE, SALEM, OR 97302(971) 239-1146(503) 907-9933 Get Directions Write a Review

NPPES record last updated: June 1, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pacific Coast Clinic Salem Llc NPPES

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

PACIFIC COAST CLINIC SALEM LLC (NPI 1669704805) is a healthcare organization registered as an adult mental health in Salem, Oregon and active in the NPI registry since February 2010. The organization lists Erum Ayaz Khaleeq, Psychiatrist, as its authorized official.

NPPES Registry Identity

NPI1669704805
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NamePACIFIC COAST CLINIC SALEM LLC
Location Address1249 FAIRVIEW AVE SESalem, OR 97302-2534
Mailing Address1249 Fairview Ave SeSalem, OR 97302-2534 · (971) 239-1146 · Fax (503) 907-9933
Phone(971) 239-1146
Fax(503) 907-9933
Organization SubpartNo
Authorized OfficialErum Ayaz KhaleeqPsychiatrist · (971) 239-1146
Enumeration DateFebruary 11, 2010
Last NPPES UpdateJune 1, 2011
✔ NPI 1669704805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License✔ Licensed in OR · MD24295
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
1249 FAIRVIEW AVE SE, Salem, OR 97302
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Other Identifiers 1

Medicare PINR148780OR

Other Providers at the Same Location NPPES 3

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

DR. RONALD LLOYD HOFELDT MD
Psychiatry & Neurology (Psychiatry)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Marion County (503) 399-7093
DR. SATYANARAYANA CHANDRAGIRI M.D.
Psychiatry & Neurology (Psychiatry)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Marion County (971) 239-1146
TARRA LEANI BAKER MSN
Nurse Practitioner (Psychiatric/Mental Health)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Marion County (971) 239-1146

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 Pacific Coast Clinic Salem LLC's NPI number?

The NPI number for Pacific Coast Clinic Salem LLC is 1669704805. It was assigned to this organization in the NPPES registry on February 11, 2010.

Where is Pacific Coast Clinic Salem LLC located?

Pacific Coast Clinic Salem LLC is located at 1249 Fairview Ave SE, Salem, OR 97302. The listed phone number is (971) 239-1146.

What is Pacific Coast Clinic Salem LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Pacific Coast Clinic Salem LLC was last updated on June 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.