Provider Demographics
NPI:1255678165
Name:WILLAMETTE SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:WILLAMETTE SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DENTAL SLEEP MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHMJEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE SKARADA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-485-2578
Mailing Address - Street 1:3099 RIVER RD S
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9754
Mailing Address - Country:US
Mailing Address - Phone:503-485-2578
Mailing Address - Fax:503-485-2590
Practice Address - Street 1:3099 RIVER RD S
Practice Address - Street 2:SUITE 250
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:503-485-2578
Practice Address - Fax:503-485-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty