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General NPI Number Information
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NPI Number | 1215983200
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Entity Type | Organization
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Legal Business Name | NORTHWEST ACUTE CARE SPECIALISTS PC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 825 NE MULTNOMAH ST SUITE 1155
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City | PORTLAND
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State | OR
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Zip | 97232-2135
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Country | US
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Telephone | 503-464-9034
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Fax | 503-464-9035
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Provider Business Mailing Address
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Address Line | PO BOX 11810
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City | WESTMINSTER
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State | CA
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Zip | 92685-1810
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Country | US
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Telephone | 562-809-3540
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Fax | 562-468-0504
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT JOHN VISSERS
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Credential | M.D.
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Telephone | 503-464-9034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N/A
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License Number State |
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