| NW Headache Center, LLC | |
|
1042 Nw Norman Ave Ste 210 Gresham OR 97030-5554 | |
| (503) 665-1115 | |
| Not Available |
| Full Name | NW Headache Center, LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1042 Nw Norman Ave Ste 210, Gresham, Oregon |
| Authorized Official Name and Position | Curtis Bedont (MEMBER/MANAGER) |
| Authorized Official Contact | 5036651115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| NW Headache Center, LLC 1042 Nw Norman Ave Ste 210 Gresham OR 97030-5554 Ph: (503) 665-1115 | NW Headache Center, LLC 1042 Nw Norman Ave Ste 210 Gresham OR 97030-5554 Ph: (503) 665-1115 |
| NPI Number | 1386012029 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 09/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386012029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D9440 (Oregon) | Primary |
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