# PNW MANAGEMENT GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Vascular Centers Portland
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588283154
- **Authorized official:** DR. MARY M COSTANTINO MD (PHYSICIAN OWNER)
- **Authorized official phone:** (503) 683-7730

## Contact information

- **Practice address:** 6958 SW VARNS ST, PORTLAND, OR 97223-8281
- **Practice address phone:** (503) 683-7730
- **Practice address fax:** (503) 914-0927
- **Mailing address:** 6958 SW VARNS ST, PORTLAND, OR 97223-8281
- **Mailing address phone:** (503) 683-7730
- **Mailing address fax:** (503) 914-0927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2020
- **Last updated:** 01/26/2022