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RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC NPI 1801139019


NPI Information

NPI: 1801139019
Provider Name: RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 38D2085375

Address:
9925 SW NIMBUS AVE
SUITE 100
BEAVERTON, OR
ZIP 97008
Phone: (503) 535-8302
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RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC is a pain medicine physical medicine rehabilitation in Beaverton, OR. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC NPI is 1801139019. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9925 SW NIMBUS AVE
SUITE 100
BEAVERTON, OR
ZIP 97008
Phone: (503) 535-8302
Fax: (503) 416-8732

The provider's authorized official is Rahul Naven Desai .
The authorized official title is Owner / Ceo and has the following contact phone number (503) 535-8302.

The CLIA number assigned to this NPI record is 38D2085375 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2013 and was last updated on 10/10/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0204XRadiologyVascular & Interventional RadiologyMD28444OREGONNo
22081P2900XPhysical Medicine & RehabilitationPain MedicineDO150752OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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