Organization
PATHWAYMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY ROBERTSON (CAO)
(503) 535-8095
Entity
Organization
Contact information
Practice address
1050 SW 6TH AVE STE 1100, PORTLAND, OR 97204-1153
(503) 535-8095
Mailing address
1050 SW 6TH AVE STE 1100, PORTLAND, OR 97204-1153
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
246ZC0007X
Surgical Assistant
—
—
Other
Enumeration date
10/16/2025
Last updated
10/16/2025
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