Healthcare Provider Details

I. General information

NPI: 1538892054
Provider Name (Legal Business Name): JOSEPH VINCENT AUFHEIMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 CENTER ST NE
SALEM OR
97301-2682
US

IV. Provider business mailing address

2600 CENTER ST NE
SALEM OR
97301-2682
US

V. Phone/Fax

Practice location:
  • Phone: 503-945-2800
  • Fax:
Mailing address:
  • Phone: 503-945-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number855418
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: