# PORTLAND IOM, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508173204
- **Authorized official:** MRS. CHRISTINA COOK PH.D., M.S. (CEO/PRESIDENT)
- **Authorized official phone:** (615) 522-1332

## Contact information

- **Practice address:** DC2 209 10TH AVE S, SUITE 232, NASHVILLE, TN 37203
- **Practice address phone:** (615) 712-9574
- **Mailing address:** 209 10TH AVE SOUTH, SUITE 232, NASHVILLE, TN 37203
- **Mailing address phone:** (615) 712-9574
- **Mailing address fax:** (615) 730-8475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2010
- **Last updated:** 09/02/2010