Provider Demographics
NPI:1497146534
Name:NORTHWEST SLEEP THERAPY
Entity Type:Organization
Organization Name:NORTHWEST SLEEP THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:B
Authorized Official - Last Name:FRANKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-390-5417
Mailing Address - Street 1:4320 CHERRY AVE NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4855
Mailing Address - Country:US
Mailing Address - Phone:503-390-5417
Mailing Address - Fax:503-463-4663
Practice Address - Street 1:4320 CHERRY AVE NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4855
Practice Address - Country:US
Practice Address - Phone:503-390-5417
Practice Address - Fax:503-463-4666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD89801223G0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR7373530001Medicare NSC