Organization
NEUROTECH NORTHWEST, LLC
Active
Parent organization
NEUROTECH NORTHWEST, LLC
Other names
Neurotech Idaho
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEUROTECH NORTHWEST, LLC
Authorized official
LANCE MORGAN (DIRECTOR OF OPERATIONS)
(262) 754-0898
Entity
Organization
Contact information
Practice address
1402 140TH PL NE STE 105, BELLEVUE, WA 98007-3943
(425) 455-0446
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 754-0898
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
09/09/2015
Last updated
07/21/2022
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