| Nara Nw-madison | |
|
1776 Sw Madison St Portland OR 97205 | |
| (503) 224-1044 | |
| (503) 621-2235 |
| Full Name | Nara Nw-madison |
|---|---|
| Speciality | Clinic/Center |
| Location | 1776 Sw Madison St, Portland, Oregon |
| Authorized Official Name and Position | Sarah Ayers (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5033679089 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nara Nw-madison 1776 Sw Madison St Portland OR 97205 Ph: (503) 224-1044 | Nara Nw-madison 1776 Sw Madison St Portland OR 97205 Ph: (503) 224-1044 |
| NPI Number | 1851380828 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 03/29/2024 |
| Medicare PECOS PAC ID | 2668361585 |
|---|---|
| Medicare Enrollment ID | O20040921000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851380828 | NPI | - | NPPES |
| 126370 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 440955 (Oregon) | Primary |
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