Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sean Stack, MD

Individual provider Diagnostic Radiology Physician · NPI 1962453217

Sean Stack, MD is a Diagnostic Radiology in Salem, Oregon. Graduated from Oregon Health Sciences University School of Medicine in 1994, 32 years ago. Practices with Santiam Memorial Hospital, a 125-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
32
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone: (503) 399-1264
Fax: (503) 371-0777
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X · Licence MD20801 (OR)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 20801 (OR)

Record details

NPI number1962453217
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 12, 2006
Last updated in NPPESNovember 22, 2023
Certification dateNovember 22, 2023
Mailing address2925 Ryan Dr Se, Salem, OR 97301-9687

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice Santiam Memorial Hospital — 125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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