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NPI Code Detail

MEDICARE: ISAIAH FABIAN DE ALBA

MEDICARE: ISAIAH FABIAN DE ALBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOR

General Provider Information

NPI Number : 1649138199
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAIAH FABIAN DE ALBA
Provider Business Mailing Address
First Line : 12390 NW BARNES RD APT 281
Second Line :
City : PORTLAND
State : OR
Zip : 97229-6048
Country : US
Telephone Number : 626-756-7912
Fax Number :
Provider Business Practice Location Address
First Line : 4900 SW GRIFFITH DR STE 157
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-2977
Country : US
Telephone Number : 503-444-8230
Fax Number : 503-295-4036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ ISAIAH FABIAN DE ALBA ” Practice Location

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