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General NPI Number Information
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NPI Number | 1023007093
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Entity Type | Organization
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Legal Business Name | NATIVE AMERICAN REHABILITATION ASSOC INC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 17645 NW SAINT HELENS RD
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City | PORTLAND
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State | OR
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Zip | 97231-1729
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Country | US
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Telephone | 503-621-1069
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Fax | 503-621-0200
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MS. SARAH AYERS
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Credential |
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Telephone | 503-367-9089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 700032
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License Number State | OR
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