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General NPI Number Information
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NPI Number | 1336274372
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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 | 02/22/2007
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 703 NE HANCOCK ST
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City | PORTLAND
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State | OR
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Zip | 97212-3955
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Country | US
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Telephone | 503-230-9875
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Fax | 503-331-2677
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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 | 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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | RP-0002059
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License Number State | OR
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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 |
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License Number State |
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