Provider Demographics
NPI:1255226544
Name:ABDIRAHMAN, ABDIRAHMAN
Entity type:Individual
Prefix:
First Name:ABDIRAHMAN
Middle Name:
Last Name:ABDIRAHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10706 SW CAPITOL HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-6871
Mailing Address - Country:US
Mailing Address - Phone:503-481-3565
Mailing Address - Fax:
Practice Address - Street 1:10706 SW CAPITOL HWY APT 62
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-6880
Practice Address - Country:US
Practice Address - Phone:503-481-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator