# NORTHWEST SPINE AND LASER SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1578817078
- **Authorized official:** DR. DARRELL C BRETT MD (PRESIDENT)
- **Authorized official phone:** (503) 253-6886

## Contact information

- **Practice address:** 8995 SW MILEY RD, SUITE 204, WILSONVILLE, OR 97070-5484
- **Practice address phone:** (267) 760-4734
- **Mailing address:** 8995 SW MILEY RD, SUITE 204, WILSONVILLE, OR 97070-5484
- **Mailing address phone:** (267) 760-4734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/05/2012
- **Last updated:** 11/05/2012