| Columbia Asthma And Allergy Clinic | |
|
10373 Ne Hancock St Ste 128 Portland OR 97220-3873 | |
| (971) 220-2202 | |
| (888) 468-7648 |
| Full Name | Columbia Asthma And Allergy Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 10373 Ne Hancock St Ste 128, Portland, Oregon |
| Authorized Official Name and Position | Rajeev Jain (COO) |
| Authorized Official Contact | 4084760624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Asthma And Allergy Clinic 43575 Mission Blvd # 716 Fremont CA 94539-5831 Ph: (360) 609-7077 | Columbia Asthma And Allergy Clinic 10373 Ne Hancock St Ste 128 Portland OR 97220-3873 Ph: (971) 220-2202 |
| NPI Number | 1184804064 |
|---|---|
| Provider Enumeration Date | 11/08/2007 |
| Last Update Date | 10/13/2023 |
| Medicare PECOS PAC ID | 3072602119 |
|---|---|
| Medicare Enrollment ID | O20071128000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184804064 | NPI | - | NPPES |
| 078477 | Medicaid | OR | |
| 8188047 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kuo C Chang |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1518940162 PECOS PAC ID: 9739082504 Enrollment ID: I20040217000068 |
| Provider Name | Michael J Noonan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1124166244 PECOS PAC ID: 0648169946 Enrollment ID: I20110315000284 |
| Provider Name | Sanjeev Jain |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1710973839 PECOS PAC ID: 1759313604 Enrollment ID: I20130710000032 |
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