DR. DAVID NORTHWAY PHD
Clinical Neuropsychologist
Eugene, Oregon
Provider NPI: 1972698140
Provider Information:DR. DAVID NORTHWAY PHD
Gender: M
Sole Proprietor
Practice Location:
291 WEST 12TH ST. EUGENE, OR 97401 US
Tel: 541-683-1104 Fax: --
Business Mailing Address:
291 WEST 12TH ST. EUGENE, OR 97401 US
Tel: -- Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | OR | 1135 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | OR | 1135 |
X | 103TF0200X | Behavioral Health & Social Service Providers Psychologist | OR | 1135 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
OMAP | 045034 | OR | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin