Organization
NORTHWEST NEURO-OPHTHALMOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT EGAN M.D. (OWNER/MEMBER)
(503) 291-1422
Entity
Organization
Contact information
Practice address
1585 SW MARLOW AVE, STE 110, PORTLAND, OR 97225-5176
(503) 291-1422
(503) 297-8129
Mailing address
1585 SW MARLOW AVE, STE 110, PORTLAND, OR 97225-5176
(503) 291-1422
(503) 297-8129
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500693068
—
OR
Enumeration date
09/09/2015
Last updated
10/28/2015
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