Organization
NORTHWEST IMAGING FORUMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT WILSON BS (PRESIDENT)
(541) 683-4930
Entity
Organization
Contact information
Practice address
1504 EYRIE LN, EUGENE, OR 97402-7560
(541) 683-4930
(541) 683-8499
Mailing address
PO BOX 25909, EUGENE, OR 97402-0461
(541) 683-4930
(541) 683-8499
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
612449256
DUNS NUMBER
OR
Enumeration date
12/22/2015
Last updated
12/22/2015
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