Northwest Neurology Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

License

14509 Issued in OR

Legal business name

NORTHWEST NEUROLOGY CLINIC

Practice address

10202 SE 32ND Ave
Suite 703
Milwaukie, OR 97222-3625

Phone

(503) 652-2487

Fax

(503) 652-2597

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gajanan Nilaver, M.D.

Title

Owner

Phone

(503) 652-2487

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1750416848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "SUITE 703",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223625",
            "telephone_number": "503-652-2487",
            "fax_number": "503-652-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "SUITE 703",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223625",
            "telephone_number": "503-652-2487",
            "fax_number": "503-652-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST NEUROLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "NILAVER",
        "authorized_official_first_name": "GAJANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-652-2487",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "14509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130708",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest ENT and Allergy Care Inc
• Northwest ENT, Allergy and Sleep Associates, LLC
• Northwest Extremity Specialists LLC
• Northwest Housing Alternatives
• Northwest Natural Medicine, LLC
• Northwest Primary Care Group PC
• Northwest Primary Care Group PC
• Northwest Primary Care Group, PC
• Keith Randal Norton, DDS
• Nova Radiology, P.C

• Specialist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.