Provider Demographics
NPI:1427396266
Name:NWSA INC
Entity Type:Organization
Organization Name:NWSA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEERING-LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:CST/FA
Authorized Official - Phone:503-869-8729
Mailing Address - Street 1:31143 SW WILLAMETTE WAY W
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8546
Mailing Address - Country:US
Mailing Address - Phone:503-869-8729
Mailing Address - Fax:
Practice Address - Street 1:31143 SW WILLAMETTE WAY W
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8546
Practice Address - Country:US
Practice Address - Phone:503-869-8729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR103817284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital