Provider Demographics
NPI:1407882772
Name:NORTHWEST OCCUPATIONAL MEDICINE CENTER INC.
Entity Type:Organization
Organization Name:NORTHWEST OCCUPATIONAL MEDICINE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-684-7246
Mailing Address - Street 1:9400 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3315
Mailing Address - Country:US
Mailing Address - Phone:503-684-7246
Mailing Address - Fax:503-624-0724
Practice Address - Street 1:9400 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3315
Practice Address - Country:US
Practice Address - Phone:503-684-7246
Practice Address - Fax:503-624-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135081Medicare PIN