Unknown Individual – Internal Medicine Physician, NPI 1689610255
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3158, Southwest 87th Avenue, Portland, Metro, Washington County, Oregon, 97225, United States
PORTLAND, OR 972083158
Phone: (503) 215-6494
Fax: (503) 215-6644
Type: Mailing
12442, Southwest Scholls Ferry Road, Englewood Park, Tigard, Metro, Washington County, Oregon, 97223, United States
SUITE 106
TIGARD, OR 972233396
Phone: (503) 216-9200
Fax: (503) 216-9220
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.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
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 ·
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 97208)
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