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General NPI Number Information
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NPI Number | 1427396266
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Entity Type | Organization
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Legal Business Name | NWSA INC
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 31143 SW WILLAMETTE WAY W
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City | WILSONVILLE
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State | OR
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Zip | 97070-8546
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Country | US
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Telephone | 503-869-8729
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Fax |
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Provider Business Mailing Address
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Address Line | 31143 SW WILLAMETTE WAY W
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City | WILSONVILLE
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State | OR
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Zip | 97070-8546
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Country | US
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Telephone | 503-869-8729
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Fax |
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Authorized Official
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Title or Position | SURGICAL FIRST ASSISTANT
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Name | DEBRA ANN DEERING-LARSON
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Credential | CST/FA
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Telephone | 503-869-8729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 103817
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License Number State | OR
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