MEDICARE: SAKINEH ILIAIFAR X MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD24647	OR
2	207RP1001X	Pulmonary Disease Physician	MD24647	OR

General Provider Information

NPI Number	:	1255308631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAKINEH ILIAIFAR X MD

Provider Business Mailing Address
First Line	:	24800 SE STARK ST
Second Line	:
City	:	GRESHAM
State	:	OR
Zip	:	97030-3378
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24900 SE STARK ST
Second Line	:	SUITE #110
City	:	GRESHAM
State	:	OR
Zip	:	97030-3355
Country	:	US
Telephone Number	:	503-465-6850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	09/11/2025

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Directions to “ SAKINEH ILIAIFAR X MD” Practice Location

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