Provider Demographics
NPI:1154645190
Name:NORTHWEST NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:NORTHWEST NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENZLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-489-3879
Mailing Address - Street 1:309 E FARWELL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-8210
Mailing Address - Country:US
Mailing Address - Phone:509-489-3879
Mailing Address - Fax:509-484-1823
Practice Address - Street 1:309 E FARWELL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-8210
Practice Address - Country:US
Practice Address - Phone:509-489-3879
Practice Address - Fax:509-484-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty