Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1695 | OR |
NPI | 1699815647 |
---|---|
Provider Name | Dr. Lawrence Karl Nelson |
First Address | Wilsonville, OR 97070-2415 |
Second Address | Tigard, OR 97223-8390 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 11/10/2016 |