Provider Demographics
NPI:1538504535
Name:NAKHAI, MALIHEH M (MD)
Entity Type:Individual
Prefix:
First Name:MALIHEH
Middle Name:M
Last Name:NAKHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9047 SE FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-4617
Mailing Address - Country:US
Mailing Address - Phone:503-772-8751
Mailing Address - Fax:503-772-7910
Practice Address - Street 1:9047 SE FOSTER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-4617
Practice Address - Country:US
Practice Address - Phone:503-772-8751
Practice Address - Fax:503-772-7910
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD177580207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500677729Medicaid
ORR188876Medicare PIN