Organization
NORTHWEST SPINE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMERALD LOUISE NELSON FLORES (CLINIC ADMINISTRATOR)
(971) 277-0559
Entity
Organization
Contact information
Practice address
10,000 SE MAIN ST ST 360, PORTLAND, OR 97216
(503) 253-4000
(503) 253-4002
Mailing address
10000 SE MAIN ST STE 360, PORTLAND, OR 97216-2474
(503) 253-4000
(503) 253-4002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
03/26/2024
Last updated
07/10/2024
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