| NPI | 1336311554 |
|---|---|
| Doing Business As | PROVIDENCE NEUROLOGICAL SPECIALTIES PPMC |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-593-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 363LF0000X Nurse Practitioner, Family | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2012-09-10 |