Individual provider · NPI-1

Maryan Abdulkadir

Nurse Practitioner · Portland, OR

NPI number1295447654
StatusActive
Last updated in NPPESOct 1, 2025

Details

NPI
1295447654
Entity type
Individual (NPI-1)
Name
Maryan Abdulkadir
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 16, 2022
Certification date
Oct 1, 2025
Last updated
Oct 1, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner10050196ORYes

Practice location

12710 Se Division St
Portland, OR 97236-3134

Phone 503-988-5558

Mailing address

12710 Se Division St
Portland, OR 97236-3134

Phone 503-988-5558

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner providers in Portland, OR