# NORTHSTAR NEUROLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528015039
- **Authorized official:** DR. RICHARD LYNN KOLLER MD (MANAGING PARTNER)
- **Authorized official phone:** (541) 330-6463

## Contact information

- **Practice address:** 2275 NE DOCTORS DR, STE 9, BEND, OR 97701-6324
- **Practice address phone:** (541) 330-6463
- **Practice address fax:** (541) 330-1490
- **Mailing address:** 2275 NE DOCTORS DR, STE 9, BEND, OR 97701-6324
- **Mailing address phone:** (541) 330-6463
- **Mailing address fax:** (541) 330-1490

## Taxonomy

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

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 08/22/2020