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General NPI Number Information
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NPI Number | 1730588542
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Entity Type | Organization
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Legal Business Name | NORTHWEST SLEEP ASSOCIATES
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 230 COLUMBIA BLVD
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City | SAINT HELENS
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State | OR
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Zip | 97051-2062
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Country | US
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Telephone | 503-366-2602
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Fax | 503-397-3856
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Provider Business Mailing Address
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Address Line | 230 COLUMBIA BLVD
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City | SAINT HELENS
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State | OR
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Zip | 97051-2062
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Country | US
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Telephone | 503-366-2602
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Fax | 503-397-3856
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Authorized Official
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Title or Position | OWNER
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Name | KEITH LASZLO VALACHI
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Credential | DDS
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Telephone | 503-702-8308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D6487
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License Number State | OR
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