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Organization

RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAHUL NAVEN DESAI MD (OWNER / CEO)
(503) 535-8302
Entity
Organization

Contact information

Practice address
9925 SW NIMBUS AVE, SUITE 100, BEAVERTON, OR 97008
(503) 535-8302
(503) 416-8732
Mailing address
9925 SW NIMBUS AVE., SUITE 100, BEAVERTON, OR 97008
(503) 535-8302
(503) 416-8732

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
DO150752
OR
2085R0204X
Vascular & Interventional Radiology Physician
MD28444
OR

Other

Enumeration date
04/05/2013
Last updated
10/10/2016
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