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General NPI Number Information
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NPI Number | 1942841176
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Entity Type | Individual
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Provider Name | KIMIA IGHANI NEWELL PAC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2019
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 800 SW 13TH AVE
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City | PORTLAND
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State | OR
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Zip | 97205-1999
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Country | US
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Telephone | 503-221-0161
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Fax |
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Provider Business Mailing Address
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Address Line | 409 NW SUNDOWN WAY
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City | PORTLAND
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State | OR
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Zip | 97229-6578
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Country | US
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Telephone | 503-944-9081
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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