Unknown Individual – Contractor, NPI 1194933259
Contractor
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3758, Southeast Milwaukie Avenue, Brooklyn, Portland, Metro, Multnomah County, Oregon, 97202, United States
PORTLAND, OR 972023805
Phone: (503) 752-2999
Type: Location
4206 SE SALMON ST APT A
PORTLAND, OR 972152476
Phone: (503) 752-2999
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97202)
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