| NPI | 1770980401 |
|---|---|
| Doing Business As | PORTLAND MLK DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAMUEL T. WEY Sr Director Licensure&Certification 615-341-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2023-09-07 |