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General NPI Number Information
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NPI Number | 1609887413
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Entity Type | Organization
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Legal Business Name | CSS JV, LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 11782 SW BARNES RD #200
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City | PORTLAND
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State | OR
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Zip | 97225-5914
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Country | US
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Telephone | 503-906-4300
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Fax | 503-906-4333
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Provider Business Mailing Address
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Address Line | 11782 SW BARNES RD #200
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City | PORTLAND
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State | OR
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Zip | 97225-5914
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Country | US
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Telephone | 503-906-4300
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Fax | 503-906-4333
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TINA CASTER
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Credential |
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Telephone | 503-906-4306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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