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Individual

MR. ABDUL ALI SADIQ WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5329 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3237
(503) 988-5183
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA175884
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022959
OR
05
096511
OR
Enumeration date
04/29/2014
Last updated
07/12/2016
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