Organization
GREATER PORTLAND NEUROSURGICAL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIO ORDONEZ MD (OWNER)
(503) 665-5522
Entity
Organization
Contact information
Practice address
24900 SE STARK ST STE 209, GRESHAM, OR 97030-3382
(503) 665-5522
(503) 665-8822
Mailing address
24900 SE STARK ST STE 209, GRESHAM, OR 97030-3382
(503) 665-5522
(503) 665-8822
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD11164
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192138
—
OR
01
—
R169208
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
OR
Enumeration date
03/26/2013
Last updated
08/15/2013
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