Healthcare Provider Details

I. General information

NPI: 1730005026
Provider Name (Legal Business Name): PB HEALTH CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 HIGH ST SE STE 233
SALEM OR
97301-3620
US

IV. Provider business mailing address

161 HIGH ST SE STE 233
SALEM OR
97301-3620
US

V. Phone/Fax

Practice location:
  • Phone: 336-991-3491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PEACE BANKS,
Title or Position: OWNER
Credential:
Phone: 336-991-3491