Provider Demographics
NPI:1740585876
Name:NORTHWEST SLEEP SERVICES, LLC
Entity Type:Organization
Organization Name:NORTHWEST SLEEP SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RPSGT
Authorized Official - Phone:541-760-0167
Mailing Address - Street 1:5060 SW PHILOMATH BLVD # 166
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1044
Mailing Address - Country:US
Mailing Address - Phone:541-760-0167
Mailing Address - Fax:
Practice Address - Street 1:5060 SW PHILOMATH BLVD # 166
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-1044
Practice Address - Country:US
Practice Address - Phone:541-760-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic