Demographics
DOB: Oct 26, 1961
Sex: M
Status: active
Email: —
Mobile: 5039300251
Home: 5039300251
Department: WEST SALEM
Primary Provider: Ellen Prairie
Last Synced: Jun 17, 2026, 2:13 PM
Address: 5940 Lake Lubish Rd NE, SALEM, OR, 97305
Allergy (3)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Allergy | Apr 27, 2021 | — | |
| Allergy | Jun 26, 2018 | — | |
| Allergy | Dec 10, 2015 | — |
Problem (10)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Nov 23, 2015 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — | |
| Problem | Jan 11, 2026 | — |
Vital (7)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — | |
| Vital | Jan 9, 2026 | — |
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