MEDICARE: NORTHWEST SURGICAL SPECIALISTS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician
2	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730118803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST SURGICAL SPECIALISTS, P.C.

Provider Business Mailing Address
First Line	:	200 NE MOTHER JOSEPH PL
Second Line	:	SUITE 210
City	:	VANCOUVER
State	:	WA
Zip	:	98664-3299
Country	:	US
Telephone Number	:	360-254-6161
Fax Number	:	564-236-0173

Provider Business Practice Location Address
First Line	:	1 N CENTER COURT ST STE 110
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-2104
Country	:	US
Telephone Number	:	360-254-6161
Fax Number	:	360-803-0847

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE MGMNT
Name	:	DAWN HABKIRK
Credential	:
Telephone Number	:	360-449-6349

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	05/19/2025

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