Healthcare Provider Details

I. General information

NPI: 1891690913
Provider Name (Legal Business Name): PNWCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13805 NE FREMONT CT
PORTLAND OR
97230-2920
US

IV. Provider business mailing address

13805 NE FREMONT CT
PORTLAND OR
97230-2920
US

V. Phone/Fax

Practice location:
  • Phone: 971-303-2396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: SEGED KIDANEMARIAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-701-6244