NATIVE AMERICAN REHABILITATION ASSOCIATION NORTHWEST, INC. (NPI# 1174979934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174979934 |
| Entity Type | Organization |
| Organization Name | NATIVE AMERICAN REHABILITATION ASSOCIATION NORTHWEST, INC. |
| Other Organization Name | NARA NW-DENTAL CLINIC |
| Practice Address |
12750 Se Stark St Building E Portland OR 97233-1539 |
| Mailing Address |
1776 Sw Madison St Portland OR 97205-1715 |
| Practice Telephone | 9713473009 |
| Practice Fax Number | 9712563277 |
| Mailing Telephone | 5032241044 |
| Mailing Fax Number | 5032244494 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2017-06-22 |
| Authorized Official Name | SARAH AYERS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 9713862278 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223D0001X |
Dentist Specialization: Dental Public Health |
OR | Dental Providers | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 126370 | 05 |
| Other Name | Type Code |
|---|---|
| NARA NW-Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346520251 | Native American Rehabilitation Association Northwest, Inc. | Clinic/Center | 3716 Ne Mlk Jr Blvd, Portland, OR 97212 | 2011-08-23 |
| Street Address |
12750 SE STARK ST BUILDING E |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184666414 | Ziad Hazim | Dentist | 12750 Se Stark St, Portland, OR 97233-1539 | 2006-06-12 |
| 1467955195 | Chrystal L Davis | Dental Assistant | 12750 Se Stark St, Portland, OR 97233-1539 | 2018-03-08 |
| 1467986729 | Samantha J Metcalf | Dental Hygienist | 12750 Se Stark St, Portland, OR 97233-1539 | 2017-04-13 |
| 1346790284 | Jessica R Stratton | Dental Assistant | 12750 Se Stark St, Building E, Portland, OR 97233-1539 | 2016-10-04 |
| 1588930747 | Keith Yurevitz | Dental Hygienist | 12750 Se Stark St, Portland, OR 97233-1539 | 2012-03-31 |
| 1225238587 | Caitlin C Han | Dentist | 12750 Se Stark St, Suite E, Portland, OR 97233 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| 1144691098 | Central City Concern Inc | Clinic/Center | 2566 Ne Hoyt St, Portland, OR 97232-2323 | 2015-10-16 |
| 1295119386 | Central City Concern Inc | Clinic/Center | 12133 E. Burnside St, Portland, OR 97216-2344 | 2015-07-17 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.