Individual
MARYAN ABDULKADIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10050196
OR
Other
Enumeration date
12/16/2022
Last updated
10/01/2025
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