Northwest Surgical Specialists PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHWEST SURGICAL SPECIALISTS PC

Practice address

1040 NW 22ND Ave Ste 610
Portland, OR 97210-3066

Phone

(360) 254-6161

NPI assigned

Jul 14, 2017

Organization subpart

Yes

Parent organization

NORTHWEST SURGICAL SPECIALISTS PCAs reported in NPPES

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

Authorized official

Name

Jay L Crary, MD

Title

Authorized Official

Phone

(360) 254-6161

Specialties & licenses 1

Addresses

Other names 1

• Rebound Neurosurgery at Good Sam Other name

Part of

NW Surgical Specialists

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Northwest Surgical Specialists LLP

  • Surgery Physician
  • Springfield, OR
  • NPI 1770516544
  NPPES parent name

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1710409347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 610",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103066",
            "telephone_number": "360-254-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL SPECIALISTS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST SURGICAL SPECIALISTS PC",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "CRARY",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "360-254-6161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Neurosurgery at Good Sam",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Northwest Renal Clinic, Inc.
• Northwest Renal Clinic, Inc.
• Northwest Renal Clinic, Inc.
• Northwest Rheumatology Associates, PC
• Northwest Spine Surgery LLC
• Northwest Surgical Specialists PC
• Northwest Surgical Specialists, P.C.
• Northwest Urological Clinic PC
• Northwest Urology, LLC
• Northwest Urology, LLC

• Durable Medical Equipment & Medical Supplies in Portland, OR
• Providers in Portland, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; 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.