Northwest Diagnostic Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

12-35846 Issued in OR

Legal business name

NORTHWEST DIAGNOSTIC SERVICES

Practice address

2728 W Main St
Suite 121
Medford, OR 97501-2499

Phone

(541) 622-6088

Fax

(541) 622-6090

NPI assigned

Feb 10, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Janet Hetherington

Title

Excecutive Manager

Phone

(541) 622-6088

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1497051320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 W MAIN ST",
            "address_2": "SUITE 121",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012499",
            "telephone_number": "541-622-6088",
            "fax_number": "541-622-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 W MAIN ST",
            "address_2": "SUITE 121",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012499",
            "telephone_number": "541-622-6088",
            "fax_number": "541-622-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "HETHERINGTON",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "EXCECUTIVE MANAGER",
        "authorized_official_telephone_number": "541-622-6088"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "12-35846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R163709",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabitha Norris, RPH
• Sarah Jean North, L.M.T.
• Northland Hearing Centers, Inc.
• Northridge Senior Living, LLC
• Northwest Dental Associates -Medford LLC
• Northwest Life Chiropractic
• Northwest Medical, LLC.
• Northwest Pain Management Inc
• Northwest Pain Management PC
• Northwest Spine & Wellness Center, LLC

• Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.