Organization
NORTHWEST RENAL CLINIC, INC.
Active
Parent organization
NORTHWEST RENAL CLINIC INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST RENAL CLINIC INC
Authorized official
JONALYN HORSFALL (OFFICE MANAGER)
(503) 229-7976
Entity
Organization
Contact information
Practice address
9701 SW BARNES ROAD, SUITE 110, PORTLAND, OR 97225
(503) 595-6675
(503) 595-6679
Mailing address
1130 NW 22ND AVENUE, SUITE 640, PORTLAND, OR 97210
(503) 229-7976
(503) 274-4867
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119297
—
OR
Enumeration date
10/31/2007
Last updated
08/01/2016
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