Provider Demographics
NPI:1063512101
Name:TOWER, ROBERT NEILL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEILL
Last Name:TOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1211 NW GLISAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3054
Mailing Address - Country:US
Mailing Address - Phone:503-227-5075
Mailing Address - Fax:503-241-2793
Practice Address - Street 1:1211 NW GLISAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3054
Practice Address - Country:US
Practice Address - Phone:503-227-5075
Practice Address - Fax:503-241-2793
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00045917207W00000X
ORMD24417207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8355141Medicaid
WA8355141Medicaid
WA8862128Medicare ID - Type UnspecifiedUW PHYSICIANS