Organization Name: | PROPEL NETWORK, LLC |
NPI Number: | 1659730760 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RILEY LEVY (OPERATIONS COORDINATOR) |
Mailing Address: | 14525 Sw Millikan Way Beaverton |
State: | OR US |
Postal Code: | 970052343 |
Phone Number: | 4433426879 |
Fax Number: | |
NPI Enumeration Date: | 02/17/2016 |
NPI Last Update Date: | 02/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 126560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |