| Sawubona, Llc | |
|
1675 Sw Marlow Ave Ste 301, Portland, OR 97225-5105 | |
| (503) 469-9818 | |
| (503) 469-9870 |
| Full Name | Sawubona, Llc |
|---|---|
| Type | Facility |
| Speciality | General Practice |
| Location | 1675 Sw Marlow Ave Ste 301, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811519523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 175F00000X | Naturopath | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Aloysius N. Fobi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255350328 PECOS PAC ID: 9638242183 Enrollment ID: I20080717000218 |
| Provider Name | Kendra J Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760637920 PECOS PAC ID: 8729114046 Enrollment ID: I20100325000885 |
| Provider Name | Maxwell Elliott Muehleip |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083121859 PECOS PAC ID: 6901220102 Enrollment ID: I20200721002902 |
| Provider Name | Eric Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588262687 PECOS PAC ID: 3779994033 Enrollment ID: I20201118001418 |
| Mailing Address | Practice Location Address |
|---|---|
| Sawubona, Llc 917 Meadows Ln Se, Jefferson, OR 97352-9611 Ph: () - | Sawubona, Llc 1675 Sw Marlow Ave Ste 301, Portland, OR 97225-5105 Ph: (503) 469-9818 |