NORTHWEST RENAL CLINIC, INC. – Nephrology Physician, NPI 1528036662
Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NORTHWEST RENAL CLINIC, INC.
8050 SW Warm Springs St Ste 150
Tualatin, OR 970627422
Phone: (503) 692-7971
Fax: (503) 691-6837
Type: Location
9155 SW Barnes Rd Ste 402
Portland, OR 972256631
Phone: (503) 292-7704
Fax: (503) 292-7046
Type: Location
730 SE Oak St Ste I
Hillsboro, OR 971234245
Phone: (503) 430-0497
Fax: (503) 747-5985
Type: Location
4224 NE Halsey St Ste 300
Portland, OR 972131568
Phone: (503) 235-5509
Fax: (503) 235-5335
Type: Location
10201 SE Main St Ste 27
Portland, OR 972162937
Phone: (503) 256-0877
Fax: (503) 256-4188
Type: Location
105 Maui Lani Pkwy Ste 100
Wailuku, HI 967932443
Phone: (808) 442-7777
Fax: (808) 442-7778
Type: Location
4473 Pahee St Ste L
Lihue, HI 967662037
Phone: (808) 632-0200
Fax: (808) 632-0201
Type: Location
633 Ponahawai St Ste 103
Hilo, HI 967207601
Phone: (808) 481-2300
Fax: (808) 481-2301
Type: Location
12550 SE 93rd Ave Ste 250
Clackamas, OR 970156787
Phone: (503) 654-1153
Fax: (503) 654-7693
Type: Location
232 NE Norton Ln
McMinnville, OR 971288470
Phone: (503) 434-1159
Fax: (503) 434-1190
Type: Location
925 Commercial St SE Ste 110
Salem, OR 973024173
Phone: (503) 967-6670
Fax: (503) 691-6837
Type: Location
PO BOX 3068
PORTLAND, OR 972083068
Phone: (503) 229-7976
Fax: (503) 274-4867
Type: Mailing
1130 NW 22ND AVE STE 640
PORTLAND, OR 972102993
Phone: (503) 229-7976
Fax: (503) 274-4867
Type: Location
1130, Northwest 22nd Avenue, Northwest District, Portland, Metro, Multnomah County, Oregon, 97210, United States of America
STE 640
PORTLAND, OR 972102900
Phone: (503) 229-7976
Fax: (503) 274-4867
Type: Mailing
1130, Northwest 22nd Avenue, Nob Hill, Northwest District, Portland, Multnomah County, Oregon, 97210, United States
STE 640
PORTLAND, OR 972102993
Phone: (503) 229-7976
Fax: (503) 274-4867
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-12-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (99 days ago).
Enrollment records
1
Earliest due date
2026-02-28
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20191211003109 | O | Clinic/Group Practice | HI | 2026-02-28 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97062)
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