Organization
PACIFIC SPINE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAYE L KAISER (BOOKKEEPER)
(503) 783-0201
Entity
Organization
Contact information
Practice address
19260 SW 65TH AVE STE 270, TUALATIN, OR 97062-5705
(503) 885-9391
(503) 783-0909
Mailing address
19260 SW 65TH AVE STE 270, TUALATIN, OR 97062-5705
(503) 885-9391
(503) 783-0909
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD15842
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241875
—
OR
Enumeration date
03/09/2007
Last updated
06/25/2010
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