Provider Demographics
NPI:1437111507
Name:NORTHWEST CARDIOLOGISTS, P.C.
Entity Type:Organization
Organization Name:NORTHWEST CARDIOLOGISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:P
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-640-5737
Mailing Address - Street 1:333 SE 7TH AVE
Mailing Address - Street 2:SUITE 5200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4157
Mailing Address - Country:US
Mailing Address - Phone:503-640-5737
Mailing Address - Fax:503-681-0645
Practice Address - Street 1:333 SE 7TH AVE
Practice Address - Street 2:SUITE 5200
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-640-5737
Practice Address - Fax:503-681-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WDBCDOtherMEDICARE
OR227036Medicaid