Provider Type Icon

PACIFIC SPINE SPECIALISTS LLC NPI 1740311679


NPI Information

NPI: 1740311679
Provider Name: PACIFIC SPINE SPECIALISTS, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
19260 SW 65TH AVE STE 270
TUALATIN, OR
ZIP 97062
Phone: (503) 885-9391
Get Directions

PACIFIC SPINE SPECIALISTS, LLC is a specialist in Tualatin, OR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PACIFIC SPINE SPECIALISTS, LLC NPI is 1740311679. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

19260 SW 65TH AVE STE 270
TUALATIN, OR
ZIP 97062-705
Phone: (503) 885-9391
Fax: (503) 783-0909

The provider's authorized official is Faye L Kaiser .
The authorized official title is Bookkeeper and has the following contact phone number (503) 783-0201.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 6/25/2010.


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
1174400000XSpecialistMD15842OREGONYes

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
1A49072MEDICARE UPINOREGON
2241875MEDICAIDOREGON
3R113017MEDICARE ID-TYPE UNSPECIFIEDOREGONPRACTICE ID NUMBER
4P57863MEDICARE UPINOREGON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.