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General NPI Number Information
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NPI Number | 1700178175
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Entity Type | Individual
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Provider Name | ATHEIR IBRAHIM ABBAS MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 3710 SW US VETERANS HOSPITAL ROAD BUILDING 101, RM 514, MAILBOX R&D28
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City | PORTLAND
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State | OR
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Zip | 97239-2964
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Country | US
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Telephone | 503-220-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 330 W 58TH ST STE 304
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City | NEW YORK
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State | NY
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Zip | 10019-1801
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Country | US
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Telephone | 646-838-2227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 265637
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License Number State | NY
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