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Organization

NORTHWEST RENAL CLINIC, INC.

Active
Parent organization
NORTHWEST RENAL CLINIC, INC.
Other names
Island Kidney Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHWEST RENAL CLINIC, INC.
Authorized official
CLAYTON MICHAEL SMILEY MD (PRESIDENT / MD)
(503) 229-7976
Entity
Organization

Contact information

Practice address
105 MAUI LANI PKWY STE 100, WAILUKU, HI 96793-2443
(808) 442-7777
(808) 442-7778
Mailing address
1130 NW 22ND AVE STE 640, PORTLAND, OR 97210-5488
(503) 229-7976
(503) 274-4867

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Enumeration date
11/04/2019
Last updated
11/05/2019
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