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NPI Code Detail

MEDICARE: NATIVE AMERICAN REHABILITATION ASSOC INC

MEDICARE: NATIVE AMERICAN REHABILITATION ASSOC INC
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396734364
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIVE AMERICAN REHABILITATION ASSOC INC
Provider Business Mailing Address
First Line : 211 SE CARUTHERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4502
Country : US
Telephone Number : 503-224-1044
Fax Number : 971-260-0355
Provider Business Practice Location Address
First Line : 703 NE HANCOCK ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-3955
Country : US
Telephone Number : 503-230-9875
Fax Number : 503-331-3441
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : SARAH AYERS
Credential :
Telephone Number : 503-367-9089
Provider Enumeration Date : 10/20/2005
Last Update Date : 03/11/2025

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Directions to “NATIVE AMERICAN REHABILITATION ASSOC INC ” Practice Location

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