Healthcare Provider Details

I. General information

NPI: 1497146534
Provider Name (Legal Business Name): NORTHWEST SLEEP THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 CHERRY AVE NE
KEIZER OR
97303-4855
US

IV. Provider business mailing address

4320 CHERRY AVE NE
KEIZER OR
97303-4855
US

V. Phone/Fax

Practice location:
  • Phone: 503-390-5417
  • Fax: 503-463-4666
Mailing address:
  • Phone: 503-390-5417
  • Fax: 503-463-4663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD8980
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JENNIFER B FRANKEL
Title or Position: OWNER
Credential: DMD
Phone: 503-390-5417