Organization
ISD RENAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
3524 NE SANDY BLVD, PORTLAND, OR 97232-1961
(503) 236-7097
(503) 236-8110
Mailing address
5200 VIRGINIA WAY, LICENSURE & CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/25/2006
Last updated
10/15/2020
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