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WILLAMETTE VALLEY WEIGHT LOSS, LLC
NPI 1760998355
Clinic/Center in Salem, OR

Active since December 19, 2017CLIA Certified · 4 labs
1174 CORNUCOPIA ST NW STE 240, SALEM, OR 97304(971) 301-4411(971) 999-7006 Get Directions Write a Review

NPPES record last updated: January 7, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 7, 2019, Nov 8, 2018, Dec 19, 2017 (3 updates tracked since 2017).

About Willamette Valley Weight Loss, Llc NPPES

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

WILLAMETTE VALLEY WEIGHT LOSS, LLC (NPI 1760998355) is a healthcare organization registered as a clinic/center in Salem, Oregon and active in the NPI registry since December 2017. The organization holds 4 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Aubrey Lynn Harding, Owner, as its authorized official.

NPPES Registry Identity

NPI1760998355
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameWELL LIFE FAMILY MEDICINE, LLC
Location Address1174 CORNUCOPIA ST NW STE 240Salem, OR 97304
Mailing Address1174 Cornucopia St Nw Ste 240Salem, OR 97304-3193 · (971) 301-4411 · Fax (971) 999-7006
Phone(971) 301-4411
Fax(971) 999-7006
Organization SubpartNo
Authorized OfficialAubrey Lynn HardingOwner · (971) 301-4411
Enumeration DateDecember 19, 2017
Last NPPES UpdateJanuary 7, 20193 updates tracked since enumeration
✔ NPI 1760998355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in OR · 3012
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1174 CORNUCOPIA ST NW STE 240, Salem, OR 97304
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Other Names 1

Doing Business AsWillamette Valley Weight Loss, Llc

Secondary Practice Locations 3

Location 12651 Commercial St SE Ste 1Salem, OR 97302-4872 · Phone (971) 301-4411 · Fax (971) 999-7006
Location 21675 SW Marlow Ave Ste 307Portland, OR 97225-5105 · Phone (971) 301-4411 · Fax (971) 999-7006
Location 3858 Commercial St NESalem, OR 97301-1016 · Phone (971) 301-4411 · Fax (971) 999-7006

Other Identifiers 1

Medicaid500694138OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willamette Valley Weight Loss, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Willamette Valley Weight Loss, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner5
Family Practice4
Internal Medicine1
Mental Health Counselor1

Clinicians, nearest first (11)

Evelin Dacker, M.D.
Family Practice
NPI 1861479396
1105 LIBERTY ST SE
Salem, OR 97302
(971) 225-3331
✔ PECOS1.5 mi
Isaac Lichtenstein, MD, RN
Family Practice
NPI 1962147603
3600 NW SAMARITAN DR
Corvallis, OR 97330
(541) 768-4906
✔ PECOS✔ Accepts Medicare26 mi
David Ramsay
Mental Health Counselor
NPI 1447927314
256 SE 2ND AVE
Hillsboro, OR 97123
(971) 301-4411
✔ PECOS✔ Accepts Medicare39 mi
Emily Charlton, FNP
Nurse Practitioner
NPI 1407330889
4660 NE BELKNAP CT STE 119
Hillsboro, OR 97124
(503) 359-4773
✔ PECOS✔ Accepts Medicare40 mi
Denise Tobe, FNP-C
Nurse Practitioner
NPI 1235503277
3325 SE HAWTHORNE BLVD
Portland, OR 97214
(503) 684-8252
✔ PECOS✔ Accepts Medicare44 mi
Brian Hopkins, DO
Family Practice
NPI 1992248355
777 N RAYMOND ST
Boise, ID 83704
(208) 514-2500
✔ PECOS✔ Accepts Medicare349 mi
Patrick Testa, PMHNP
Nurse Practitioner
NPI 1588303937
1166 E WARNER RD
Gilbert, AZ 85296
(480) 716-5280
✔ PECOS✔ Accepts Medicare1,003 mi
Dale Lachance, NURSE PRACTITIONER
Nurse Practitioner
NPI 1568937563
201 HOSPITAL DR
Dover, OH 44622
(330) 343-6631
✔ PECOS✔ Accepts Medicare2,115 mi
Sreshtha Singh, D.O.
Internal Medicine
NPI 1174214985
4818 BLUFFTON PKWY
Bluffton, SC 29910
(843) 706-0600
✔ PECOS✔ Accepts Medicare2,414 mi
Emani Cheng, PMHNP-BC
Nurse Practitioner
NPI 1215682919
993 45TH ST
Mangonia Park, FL 33407
(561) 257-3348
✔ PECOS✔ Accepts Medicare2,678 mi
Aaron Erez, D.O.
Family Practice
NPI 1184018079
8642 VILLA LA JOLLA DR UNIT, #1
La Jolla, CA 92037
(858) 255-0770
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2160401

Well Life Family Medicine LLC · Salem, OR
Active · expires Jan 9, 2027
CLIA Number38D2160401
Laboratory TypePhysician Office
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorAubrey L. Harding
Laboratory Phone(971) 301-4411
Laboratory LocationWell Life Family Medicine LLC1174 Cornucopia St NW Suite 240, Salem, OR 97304
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D2346683

Well Life Family Medicine LLC · Woodburn, OR
Active · expires Jul 5, 2028
CLIA Number38D2346683
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2026
Certificate Expiration DateJuly 5, 2028
Laboratory DirectorAubrey L. Harding
Laboratory Phone(971) 301-4411
Laboratory LocationWell Life Family Medicine LLC693 Ray J Glatt Circle, Woodburn, OR 97071
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D2173027

Welllife Family Medicine LLC · Hillsboro, OR
Active · expires Oct 2, 2027
CLIA Number38D2173027
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorAubrey L. Harding
Laboratory Phone(971) 301-4411
Laboratory LocationWelllife Family Medicine LLC256 SE 2nd Ave, Hillsboro, OR 97123
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D2317977

Well Life Medicine LLC · Salem, OR
Active · expires Feb 3, 2027
CLIA Number38D2317977
Laboratory TypePhysician Office
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorAubrey L. Harding
Laboratory Phone(971) 301-4411
Laboratory LocationWell Life Medicine LLC1610 12th St SE, Salem, OR 97302
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Well Life Family Medicine, LLC's NPI number?

The NPI number for Well Life Family Medicine, LLC is 1760998355. It was assigned to this organization in the NPPES registry on December 19, 2017. The provider is doing business as Willamette Valley Weight Loss, LLC.

Where is Well Life Family Medicine, LLC located?

Well Life Family Medicine, LLC is located at 1174 Cornucopia St NW Ste 240, Salem, OR 97304. The listed phone number is (971) 301-4411.

What is Well Life Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Well Life Family Medicine, LLC enrolled in Medicare?

Yes. Well Life Family Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Well Life Family Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to Well Life Family Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Family Practice (4) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Well Life Family Medicine, LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Well Life Family Medicine, LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Well Life Family Medicine, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Well Life Family Medicine, LLC was last updated on January 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.