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PAIN RELIEF SPECIALIST NORTHWEST PC NPI 1396783023


NPI Information

NPI: 1396783023
Provider Name: PAIN RELIEF SPECIALIST NORTHWEST PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

Address:
831 NW COUNCIL DR
SUITE 300
GRESHAM, OR
ZIP 97030
Phone: (503) 382-8100
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PAIN RELIEF SPECIALIST NORTHWEST PC is an interventional pain medicine pain medicine in Gresham, OR. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. PAIN RELIEF SPECIALIST NORTHWEST PC NPI is 1396783023. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

831 NW COUNCIL DR
SUITE 300
GRESHAM, OR
ZIP 97030-721
Phone: (503) 382-8100
Fax: (503) 382-8120

The provider's authorized official is Edward Alan Mccluskey .
The authorized official title is Owner Operator and has the following contact phone number (503) 382-8100.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 5/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208VP0014XPain MedicineInterventional Pain Medicine648952OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CK2353OTHERRR MEDICARE
2R105591MEDICARE ID-TYPE UNSPECIFIEDOREGON
3808594000OTHERREGENCE
4307446OTHERMHN
5O166607OTHERWASHINGTONLABOR & IND
67118037MEDICAIDWASHINGTON
7130333MEDICAIDOREGON
81391489OTHERHEALTH CARE RESOURCES NW
98859469MEDICARE PINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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