Organization
TOTAL RENAL CARE INC
Active
Other names
Portland MLK Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2737 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3037
(503) 282-1253
(503) 528-8420
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500716538
—
OR
Enumeration date
11/24/2014
Last updated
04/11/2025
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