Provider Demographics
NPI:1376785238
Name:SLEEP SOLUTIONS NORTHWEST, LLC
Entity Type:Organization
Organization Name:SLEEP SOLUTIONS NORTHWEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:W
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-702-8623
Mailing Address - Street 1:5100 N BROOKLINE AVE
Mailing Address - Street 2:STE. 325
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-3623
Mailing Address - Country:US
Mailing Address - Phone:405-949-0060
Mailing Address - Fax:405-949-0412
Practice Address - Street 1:5100 N BROOKLINE AVE
Practice Address - Street 2:STE. 325
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3623
Practice Address - Country:US
Practice Address - Phone:405-949-0060
Practice Address - Fax:405-949-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic