NPIMap

Organization Active NPI

Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1174979934
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NATIVE AMERICAN REHABILITATION ASSOC INC
Practice address
12750 SE Stark St BLDG E
Portland, OR 97233-1539
Phone
(971) 347-3009
Fax
(971) 256-3277
NPI assigned
May 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ray Dunn
Title
Payroll & Workforce Comp. Director
Phone
(971) 288-9121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

12750 SE Stark St BLDG E
Portland, OR 97233-1539

Mailing address

PO Box 1569
Attention Credentialing
Portland, OR 97207-1569
Phone (503) 224-1044

Other identifiers 2

IdentifierTypeStateIssuer
126370MedicaidOR
2273799MedicaidWA

Other names 3

  • NARA NW Doing business as
  • NARA NW-Dental Clinic Doing business as
  • NATIVE AMERICAN REHABILITATION ASSOCIATION OF THE NORTHWEST, INC. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001435 OR Part B Supplier - Clinic/Group Practice 2668361585 Receives reassigned benefits from 40 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Gresham, OR

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Nara NW Indian Health C10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12750 SE Stark St
Bldg E
Portland, OR 97233
Phone (971) 347-3009

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1174979934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1569",
            "address_2": "ATTENTION CREDENTIALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972071569",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SE STARK ST BLDG E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "971-347-3009",
            "fax_number": "971-256-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE AMERICAN REHABILITATION ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PAYROLL & WORKFORCE COMP. DIRECTOR",
        "authorized_official_telephone_number": "971-288-9121"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126370",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2273799",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NARA NW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NARA NW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NARA NW-Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NATIVE AMERICAN REHABILITATION ASSOCIATION OF THE NORTHWEST, INC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.