Provider Demographics
NPI:1467640979
Name:PERSONAL MOBILITY CENTER
Entity Type:Organization
Organization Name:PERSONAL MOBILITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ADAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-287-6647
Mailing Address - Street 1:5132 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2526
Mailing Address - Country:US
Mailing Address - Phone:503-287-6647
Mailing Address - Fax:503-287-2788
Practice Address - Street 1:5132 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2526
Practice Address - Country:US
Practice Address - Phone:503-287-6647
Practice Address - Fax:503-287-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies