Provider Demographics
NPI:1447966247
Name:ABBAS, NORA LISA (ND, CHW)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:LISA
Last Name:ABBAS
Suffix:
Gender:F
Credentials:ND, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2459 SE TUALATIN VALLEY HWY # 416
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7919
Mailing Address - Country:US
Mailing Address - Phone:503-972-0235
Mailing Address - Fax:
Practice Address - Street 1:1427 NW FLANDERS ST STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2646
Practice Address - Country:US
Practice Address - Phone:503-972-0235
Practice Address - Fax:503-379-1523
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR108234172V00000X
OR5001175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No172V00000XOther Service ProvidersCommunity Health Worker