MEDICARE: SAMUEL WILLIAM PACKHAM PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA222588	OR

General Provider Information

NPI Number	:	1275315525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL WILLIAM PACKHAM PA-C

Provider Business Mailing Address
First Line	:	2957 GLEN EAGLES RD
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-2737
Country	:	US
Telephone Number	:	971-386-8399
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 LIBERTY ST SE STE 200
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-4195
Country	:	US
Telephone Number	:	503-399-0652
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	06/03/2026

Similar Medicare Providers

1598834301 — DR. KAREN BOLINGER JONES SHORR ND
Practice Location Address:

960 LIBERTY ST SE STE 210
SALEM, OR
97302-4195

Practice Phone: 503-990-8395
Practice Fax: 844-778-7077

1184934085 — DR. KHIVAN KAUR OBEROI N.D.
Practice Location Address:

960 LIBERTY ST SE STE 210
SALEM, OR
97302-4195

Practice Phone: 503-893-8905
Practice Fax: 503-828-9593

1215218789 — SALEM RHEUMATOLOGY, LLC
Practice Location Address:

960 LIBERTY ST SE STE 200
SALEM, OR
97302-4195

Practice Phone: 503-399-0652
Practice Fax: 503-373-3852

1609128479 — DR. ELOISE CORTAL ND
Practice Location Address:

960 LIBERTY ST SE STE 210
SALEM, OR
97302-4195

Practice Phone: 503-990-8395
Practice Fax: 866-304-0330

1497238273 — DIANE MONICA SCHMITZ PA-C
Practice Location Address:

960 LIBERTY ST SE STE 200
SALEM, OR
97302-4195

Practice Phone: 503-399-0652
Practice Fax: 503-373-3852

1063053015 — SALEM RHEUMATOLOGY & INFUSIONS LLC
Practice Location Address:

960 LIBERTY ST SE STE 200
SALEM, OR
97302-4195

Practice Phone: 503-399-0652
Practice Fax: 503-373-3852

Directions to “ SAMUEL WILLIAM PACKHAM PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.