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General NPI Number Information
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NPI Number | 1982075909
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Entity Type | Organization
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Legal Business Name | NORTHWEST ENDOCRINOLOGY, LLC
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Dates
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Enumeration Date | 10/16/2015
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Last Update Date | 10/16/2015
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Provider Practice Location Address
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Address Line | 6485 SW BORLAND RD SUITE B
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City | TUALATIN
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State | OR
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Zip | 97062-9762
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Country | US
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Telephone | 800-363-6499
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Fax | 866-600-0813
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Provider Business Mailing Address
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Address Line | 6485 SW BORLAND RD SUITE B
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City | TUALATIN
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State | OR
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Zip | 97062-9762
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Country | US
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Telephone | 800-363-6499
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Fax | 866-600-0813
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Authorized Official
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Title or Position | OWNER
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Name | DR. TROY H DILLARD
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Credential |
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Telephone | 800-363-6499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD28838
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License Number State | OR
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