NORTHWEST RENAL CLINIC, INC. (NPI# 1396378717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396378717 |
Entity Type | Organization |
Organization Name | NORTHWEST RENAL CLINIC, INC. |
Practice Address |
925 Commercial St Se Ste 110 Salem OR 97302-4172 |
Practice Telephone | 5039676670 |
Practice Fax Number | 5035852185 |
Mailing Telephone | 5039676670 |
Mailing Fax Number | 5035852185 |
Enumeration Date | 2020-02-13 |
Last Update Date | 2020-09-25 |
Authorized Official Name | CLAYTON MICHAEL SMILEY (PRESIDENT) |
Authorized Official Telephone | 5032297976 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | NORTHWEST RENAL CLINIC, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
1396924999 | Northwest Renal Clinic, Inc. | Internal Medicine | 9701 Sw Barnes Road, Suite 110, Portland, OR 97225 | 2007-10-31 |
1780228544 | Northwest Renal Clinic, Inc. | Internal Medicine | 105 Maui Lani Pkwy Ste 100, Wailuku, HI 96793-2443 | 2019-11-04 |
1689117087 | Northwest Renal Clinic, Inc. | Internal Medicine | 12550 Se 93rd Ave, Suite 250, Clackamas, OR 97015-9786 | 2016-12-02 |
1750748901 | Northwest Renal Clinic, Inc. | Internal Medicine | 730 Se Oak St, Suite I, Hillsboro, OR 97123-4245 | 2016-01-19 |
1861700130 | Northwest Renal Clinic, Inc. | Internal Medicine | 10201 Se Main St, Suite 27, Portland, OR 97216-2937 | 2010-09-20 |
1982931333 | Northwest Renal Clinic, Inc. | Internal Medicine | 5050 Ne Hoyt St, Suite B-54, Portland, OR 97213-2991 | 2009-11-05 |
1780865642 | Northwest Renal Clinic, Inc. | Internal Medicine | 9155 Sw Barnes Rd, Suite 402, Portland, OR 97225-6625 | 2007-11-20 |
1679752273 | Northwest Renal Clinic, Inc. | Internal Medicine | 8050 Sw Warm Springs St, Suite 150, Tualatin, OR 97062-7424 | 2007-10-31 |
1528036662 | Northwest Renal Clinic, Inc. | Internal Medicine | 1130 Nw 22nd Ave, Ste 640, Portland, OR 97210-2993 | 2006-03-14 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | NORTHWEST RENAL CLINIC, INC. | 1130 Nw 22nd #640, Portland, OR 97210 |
Street Address |
925 COMMERCIAL ST SE STE 110 |
City | SALEM |
State | OR |
Zip Code | 97302-4172 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
Find all providers in zip 97302 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982662052 | Parkland Physician Services Inc | Internal Medicine | 18 Pelham Rd, Salem, NH 03079-4818 | 2006-05-01 |
1992794515 | Ana Stankovic | Internal Medicine | 31 Stiles Rd Ste 2400, Salem, NH 03079 | 2005-10-17 |
1649279035 | Denis Privalov | Internal Medicine | 875 Oak St Se Ste 5070, Salem, OR 97301-3998 | 2005-07-18 |
1326400656 | Center for Kidney and Metabolic Disorders Pllc | Internal Medicine | 31 Stiles Rd Ste 2400, Salem, NH 03079 | 2016-03-25 |
1285885160 | Hima Bindu Yalamanchili | Internal Medicine | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2008-10-09 |
1649436585 | Ken Jongho Park | Internal Medicine | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2008-07-30 |
1710164587 | Andrea R Moore | Internal Medicine | 875 Oak St Se Ste 5070, Salem, OR 97301-3998 | 2008-01-23 |
1568668929 | Yekaterina Gincherman | Internal Medicine | 875 Oak St Se, Suite 5070, Salem, OR 97301-3975 | 2007-06-22 |
1467672261 | Kidney Care Physicians LLC | Internal Medicine | 875 Oak St Se Ste 5070, Salem, OR 97301-3975 | 2007-04-26 |
1902022817 | Lance M Dicker | Internal Medicine | 875 Oak St Se, Ste 5070, Salem, OR 97301-3975 | 2007-04-18 |
Find all providers in SALEM |
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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.