Organization
WILLAMETTE VALLEY IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCISCO SOLDEVILLA MD (MANAGING MEMBER)
(971) 256-3556
Entity
Organization
Contact information
Practice address
818 SW 3RD AVE # 113, PORTLAND, OR 97204-2405
(971) 256-3556
Mailing address
818 SW 3RD AVE # 113, PORTLAND, OR 97204-2405
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
12/17/2015
Last updated
11/15/2016
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