# NORTHWEST RENAL CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHWEST RENAL CLINIC, INC.
- **Other names:** Northwest Dialysis Access Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164946984
- **Legal business name:** NORTHWEST RENAL CLINIC, INC.
- **Authorized official:** CLAYTON M SMILEY MD (MD)
- **Authorized official phone:** (503) 229-7976

## Contact information

- **Practice address:** 9701 SW BARNES RD STE 110, PORTLAND, OR 97225-6774
- **Practice address phone:** (503) 595-6675
- **Practice address fax:** (503) 595-6679
- **Mailing address:** 1130 NW 22ND AVE STE 640, PORTLAND, OR 97210-2993
- **Mailing address phone:** (503) 229-7976
- **Mailing address fax:** (503) 274-4867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2017
- **Last updated:** 07/12/2023