# NORTHWEST PAIN MANAGEMENT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Intractable Pain Centers
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104991405
- **Authorized official:** DR. THOMAS JOHN PURTZER M.D. (PRESIDENT)
- **Authorized official phone:** (541) 770-1650

## Contact information

- **Practice address:** 897 ROYAL AVE, SUITE C, MEDFORD, OR 97504-6121
- **Practice address phone:** (541) 770-1650
- **Practice address fax:** (541) 773-2470
- **Mailing address:** 897 ROYAL AVE, SUITE C, MEDFORD, OR 97504-6121
- **Mailing address phone:** (541) 770-1650
- **Mailing address fax:** (541) 773-2470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 12880 | OR | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 146753 | — | OR |
| 01 | — | DD5160 | RAILROAD MEDICARE | OR |