Provider Demographics
NPI:1225015761
Name:CHAHIN, NIZAR (MD)
Entity Type:Individual
Prefix:
First Name:NIZAR
Middle Name:
Last Name:CHAHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 SW BOND AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4501
Mailing Address - Country:US
Mailing Address - Phone:503-494-7772
Mailing Address - Fax:503-418-3283
Practice Address - Street 1:3303 SW BOND AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-7772
Practice Address - Fax:503-418-3283
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1769692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00637955OtherRAILROAD MEDICARE
NC2022865Medicare PIN
NC5909621Medicaid