Provider Demographics
NPI:1699881466
Name:ORTEGA, SALVADOR MARCIAL (MD)
Entity type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:MARCIAL
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-585-6388
Mailing Address - Fax:503-485-3959
Practice Address - Street 1:435 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-585-6388
Practice Address - Fax:503-485-3959
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR064563Medicaid
ORB03810896OtherDEA#
ORB03810896OtherDEA#
OR00WFBHQCMedicare ID - Type Unspecified