Provider Demographics
NPI:1841581048
Name:NORTHWEST NEURO NERVE MONITORING, LLC
Entity type:Organization
Organization Name:NORTHWEST NEURO NERVE MONITORING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:EVALYN
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, CASC
Authorized Official - Phone:541-228-3660
Mailing Address - Street 1:1410 OAK ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4604
Mailing Address - Country:US
Mailing Address - Phone:541-284-5358
Mailing Address - Fax:541-228-3859
Practice Address - Street 1:1410 OAK ST
Practice Address - Street 2:SUITE 100B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4604
Practice Address - Country:US
Practice Address - Phone:541-284-5358
Practice Address - Fax:541-228-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty