Individual
NURHAYATI NOORUL ISLAM
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
(503) 988-5810
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
(503) 988-5810
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW114700
OR
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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