| Nara Nw-the Clinic Pharmacy | |
|
703 Ne Hancock St Portland OR 97212-3955 | |
| (503) 230-9875 | |
| (503) 331-2677 |
| Full Name | Nara Nw-the Clinic Pharmacy |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 703 Ne Hancock St, Portland, Oregon |
| Authorized Official Name and Position | Sarah Ayers (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5033679089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nara Nw-the Clinic Pharmacy 1776 Sw Madison St Portland OR 97205-1715 Ph: (503) 224-1044 | Nara Nw-the Clinic Pharmacy 703 Ne Hancock St Portland OR 97212-3955 Ph: (503) 230-9875 |
| NPI Number | 1336274372 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 04/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336274372 | NPI | - | NPPES |
| 231981 | Medicaid | OR | |
| RP-0002059 | Other | OR | OREGON STATE PHARMACY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | RP-0002059 (Oregon) | Secondary |
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