Provider Demographics
NPI:1427188465
Name:NORTHWEST NEUROLOGICAL PLLC
Entity Type:Organization
Organization Name:NORTHWEST NEUROLOGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-747-5615
Mailing Address - Street 1:1520 W 3RD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-7040
Mailing Address - Country:US
Mailing Address - Phone:509-747-5165
Mailing Address - Fax:509-747-5133
Practice Address - Street 1:1520 W 3RD AVE STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-7040
Practice Address - Country:US
Practice Address - Phone:509-747-5165
Practice Address - Fax:509-747-5133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7117526Medicaid
WAGAB10814Medicare UPIN