| Nara Nw-madison | |
|
1776 Sw Madison St Portland OR 97205 | |
| (971) 386-2278 | |
| (503) 621-2235 |
| Full Name | Nara Nw-madison |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1776 Sw Madison St, Portland, Oregon |
| Authorized Official Name and Position | Sarah Ayers (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9713862278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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: (971) 386-2278 |
| NPI Number | 1134343213 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 04/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134343213 | NPI | - | NPPES |
| R0000WCQLV | Other | OR | PTAN (PART B) |
| 126370 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oregon) | Primary |
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