Organization
NORTHWEST NEUROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GAJANAN NILAVER M.D. (OWNER)
(503) 652-2487
Entity
Organization
Contact information
Practice address
10202 SE 32ND AVE, SUITE 703, MILWAUKIE, OR 97222-3625
(503) 652-2487
(503) 652-2597
Mailing address
10202 SE 32ND AVE, SUITE 703, MILWAUKIE, OR 97222-3625
(503) 652-2487
(503) 652-2597
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14509
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130708
—
OR
Enumeration date
02/22/2007
Last updated
11/09/2007
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