Provider Demographics
NPI:1588140263
Name:CAPITAL NEUROSURGERY SPECIALISTS
Entity type:Organization
Organization Name:CAPITAL NEUROSURGERY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BORN
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:503-399-1386
Mailing Address - Street 1:875 OAK ST SE STE 5060
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3987
Mailing Address - Country:US
Mailing Address - Phone:503-561-7246
Mailing Address - Fax:503-561-7245
Practice Address - Street 1:875 OAK ST SE STE 5060
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3987
Practice Address - Country:US
Practice Address - Phone:503-399-1386
Practice Address - Fax:503-399-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty