| Oregon Neurology Pc | |
|
19260 Sw 65th Avenue #280 Tualatin OR 97062 | |
| (503) 692-2850 | |
| (503) 692-4465 |
| Full Name | Oregon Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 19260 Sw 65th Avenue, Tualatin, Oregon |
| Authorized Official Name and Position | Todd R Devere (SECRETARY) |
| Authorized Official Contact | 5036922850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon Neurology Pc 19260 Sw 65th Avenue #280 Tualatin OR 97062 Ph: (503) 692-2850 | Oregon Neurology Pc 19260 Sw 65th Avenue #280 Tualatin OR 97062 Ph: (503) 692-2850 |
| NPI Number | 1134159353 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 04/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134159353 | NPI | - | NPPES |
| 269960 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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