Northwest Gastroenterology Clinic LLC

NPI #1407933872 in Portland, Oregon

Provider Information

NPI Number: 1407933872
Entity Type: Organization
Organization Name: Northwest Gastroenterology Clinic LLC
Primary Specialty: Specialist
Enumeration Date: Nov 1, 2006
Last Updated: Jun 15, 2015

Practice Location

Address: 1130 NW 22ND AVE STE 410
City: Portland
State: Oregon
ZIP Code: 97210-2911
Phone: (503) 229-7137

Authorized Official

Name: DR. ROLAND WILLIAM BENNETTS, MD
Title: PARTNER
Phone: (503) 229-7137

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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