Provider Demographics
NPI:1811468200
Name:TODD KUETHER TRAUMA LLC
Entity type:Organization
Organization Name:TODD KUETHER TRAUMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUETHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-319-2732
Mailing Address - Street 1:501 N GRAHAM ST STE 445
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-2002
Mailing Address - Country:US
Mailing Address - Phone:503-489-8111
Mailing Address - Fax:503-908-6800
Practice Address - Street 1:501 N GRAHAM ST STE 445
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-2002
Practice Address - Country:US
Practice Address - Phone:503-489-8111
Practice Address - Fax:503-908-6800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TODD KUETHER,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty