| Nara Nw-wellness Center Pharmacy | |
|
12360 E Burnside St Portland OR 97233-1042 | |
| (971) 279-4800 | |
| (971) 279-2763 |
| Full Name | Nara Nw-wellness Center Pharmacy |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 12360 E Burnside 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-wellness Center Pharmacy 1776 Sw Madison St Portland OR 97205-1715 Ph: (503) 224-1044 | Nara Nw-wellness Center Pharmacy 12360 E Burnside St Portland OR 97233-1042 Ph: (971) 279-4800 |
| NPI Number | 1831587856 |
|---|---|
| Provider Enumeration Date | 12/29/2014 |
| Last Update Date | 04/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831587856 | NPI | - | NPPES |
| 500703885 | Medicaid | OR | |
| RP-0003306 | Other | OR | OREGON BOARD OF PHARMACY LICENSE |
| 2106202 | Medicaid | WA |
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