# COLUMBIA PAIN AND SPINE INSTITUTE

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

## Provider details

- **NPI number:** 1972813962
- **Authorized official:** OLEG MAKSIMOV MD (PRESIDENT)
- **Authorized official phone:** (503) 915-9217

## Contact information

- **Practice address:** 689 NW BURNSIDE ROAD, GRESHAM, OR 97030
- **Practice address phone:** (503) 382-8100
- **Practice address fax:** (503) 382-8120
- **Mailing address:** 689 NW BURNSIDE ROAD, GRESHAM, OR 97030-8014
- **Mailing address phone:** (503) 382-8100
- **Mailing address fax:** (503) 382-8120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QP3300X | Pain Clinic/Center | MD 28526 | OR | — |
| 261QP3300X | Pain Clinic/Center | MD60054432 | WA | — |

## Other

- **Enumeration date:** 10/08/2010
- **Last updated:** 05/23/2021