Organization
MEDSTAR NW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM THOMAS BOOTH (MANAGING PARTNER)
(503) 616-8427
Entity
Organization
Contact information
Practice address
14523 WESTLAKE DR, LAKE OSWEGO, OR 97035-7700
(503) 616-8427
Mailing address
14523 WESTLAKE DR, LAKE OSWEGO, OR 97035-7700
(503) 616-8427
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OR
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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