Organization
NORTHWEST GASTROENTEROLOGY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROLAND WILLIAM BENNETTS MD (PARTNER)
(503) 229-7137
Entity
Organization
Contact information
Practice address
1130 NW 22ND AVE STE 410, PORTLAND, OR 97210-2911
(503) 229-7137
(503) 241-0628
Mailing address
1130 NW 22ND AVE STE 410, PORTLAND, OR 97210-2911
(503) 229-7137
(503) 241-0628
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
06/15/2015
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