Organization
IHOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M ASA JR. (VP/CEO)
(503) 519-2672
Entity
Organization
Contact information
Practice address
12045 SE PARDEE ST, PORTLAND, OR 97266-3220
(503) 519-2672
(503) 761-0320
Mailing address
12045 SE PARDEE ST, PORTLAND, OR 97266-3220
(503) 519-2672
(503) 761-0320
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
1899501978
OR
Other
Enumeration date
01/19/2015
Last updated
06/26/2018
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