Provider Demographics
NPI:1942545561
Name:NORTHWEST INTENSIVISTS, LLC
Entity Type:Organization
Organization Name:NORTHWEST INTENSIVISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-687-1712
Mailing Address - Street 1:3355 RIVERBEND DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8800
Mailing Address - Country:US
Mailing Address - Phone:541-687-1712
Mailing Address - Fax:541-687-7943
Practice Address - Street 1:3355 RIVERBEND DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-687-1712
Practice Address - Fax:541-687-7943
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OREGON LUNG SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty