Provider Demographics
NPI:1609927797
Name:MICRONEUROSURGICAL CONSULTANTS PC
Entity Type:Organization
Organization Name:MICRONEUROSURGICAL CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:VARGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-296-1172
Mailing Address - Street 1:9155 SW BARNES RD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6625
Mailing Address - Country:US
Mailing Address - Phone:503-296-1172
Mailing Address - Fax:503-296-1168
Practice Address - Street 1:9155 SW BARNES RD
Practice Address - Street 2:SUITE 440
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6625
Practice Address - Country:US
Practice Address - Phone:503-296-1172
Practice Address - Fax:503-296-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty