Provider Demographics
NPI:1720387798
Name:TODD KUETHER,LLC
Entity Type:Organization
Organization Name:TODD KUETHER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:KUETHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-885-8845
Mailing Address - Street 1:19250 SW 65TH AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7452
Mailing Address - Country:US
Mailing Address - Phone:503-885-8845
Mailing Address - Fax:
Practice Address - Street 1:19250 SW 65TH AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7452
Practice Address - Country:US
Practice Address - Phone:503-885-8845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty