Active NPI
Northwest Renal Clinic, Inc.
- Nephrology Physician
- Portland, OR
National Provider Identifier
1528036662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- NORTHWEST RENAL CLINIC, INC.
- Practice address
- 1130 NW 22ND Ave Ste 640
Portland, OR 97210-2993 - Phone
- (503) 229-7976
- Fax
- (503) 274-4867
- NPI assigned
- Mar 14, 2006
- Last updated
- Sep 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Clayton M Smiley, MD
- Title
- MD
- Phone
- (503) 229-7976
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | Primary |
Addresses
Primary practice location
1130 NW 22ND Ave Ste 640
Portland, OR 97210-2993
Mailing address
PO Box 3068
Portland, OR 97208-3068
Phone (503) 229-7976
Other practice location 1
633 Ponahawai St Ste 103
Hilo, HI 96720-7601
Phone (808) 481-2300
Other practice location 2
4473 Pahee St Ste L
Lihue, HI 96766-2037
Phone (808) 632-0200
Other practice location 3
105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443
Phone (808) 442-7777
Other practice location 4
10201 SE Main St Ste 27
Portland, OR 97216-2937
Phone (503) 256-0877
Other practice location 5
4224 NE Halsey St Ste 300
Portland, OR 97213-1568
Phone (503) 235-5509
Other practice location 6
730 SE Oak St Ste I
Hillsboro, OR 97123-4245
Phone (503) 430-0497
Other practice location 7
9155 SW Barnes Rd Ste 402
Portland, OR 97225-6631
Phone (503) 292-7704
Other practice location 8
12550 SE 93rd Ave Ste 250
Clackamas, OR 97015-6787
Phone (503) 654-1153
Other practice location 9
232 NE Norton Ln
McMinnville, OR 97128-8470
Phone (503) 434-1159
Other practice location 10
8050 SW Warm Springs St Ste 150
Tualatin, OR 97062-7422
Phone (503) 692-7971
Other practice location 11
925 Commercial St SE Ste 110
Salem, OR 97302-4173
Phone (503) 967-6670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, HI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040429000295 | OR | Part B Supplier - Clinic/Group Practice | 8628065836 |
Receives reassigned benefits from 38 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Portland, OR; Tualatin, OR; Salem, OR; McMinnville, OR; Hillsboro, OR; Clackamas, OR |
| O20191211003109 | HI | Part B Supplier - Clinic/Group Practice | 8628065836 |
Receives reassigned benefits from 17 practitioners Practice locations: Hilo, HI; Lihue, HI; Wailuku, HI |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Northwest Dialysis Access Center
- Ambulatory Surgical Clinic/Center
- Portland, OR
- NPI 1164946984
8628065836
Other NPIs on the same Medicare enrollment 9
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0690386 | Northwest Renal Clinic | Provider-performed microscopy | Dec 30, 2027 |
National Provider Directory
National Provider DirectoryLocations
232 NE Norton Ln
McMinnville, OR 97128
Phone (503) 434-1159
925 Commercial St SE
Ste 110
Salem, OR 97302
Phone (503) 967-6670
Practitioners & affiliated clinicians
Practitioners 37
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Wailuku, HI
- NPI 1922675990
-
- Family Nurse Practitioner
- Lihue, HI
- NPI 1700457447
-
- Nurse Practitioner
- Wailuku, HI
- NPI 1932350717
-
- Nephrology Physician
- Hilo, HI
- NPI 1881919348
-
- Nephrology Physician
- Lihue, HI
- NPI 1568431666
-
- Nephrology Physician
- Wailuku, HI
- NPI 1083879803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1528036662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3068",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083068",
"telephone_number": "503-229-7976",
"fax_number": "503-274-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE STE 640",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102993",
"telephone_number": "503-229-7976",
"fax_number": "503-274-4867"
}
],
"practiceLocations": [
{
"address_1": "633 Ponahawai St Ste 103",
"address_purpose": "LOCATION",
"city": "Hilo",
"state": "HI",
"postal_code": "967207601",
"country_code": "US",
"telephone_number": "808-481-2300",
"fax_number": "808-481-2301",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4473 Pahee St Ste L",
"address_purpose": "LOCATION",
"city": "Lihue",
"state": "HI",
"postal_code": "967662037",
"country_code": "US",
"telephone_number": "808-632-0200",
"fax_number": "808-632-0201",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 Maui Lani Pkwy Ste 100",
"address_purpose": "LOCATION",
"city": "Wailuku",
"state": "HI",
"postal_code": "967932443",
"country_code": "US",
"telephone_number": "808-442-7777",
"fax_number": "808-442-7778",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10201 SE Main St Ste 27",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972162937",
"country_code": "US",
"telephone_number": "503-256-0877",
"fax_number": "503-256-4188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4224 NE Halsey St Ste 300",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972131568",
"country_code": "US",
"telephone_number": "503-235-5509",
"fax_number": "503-235-5335",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "730 SE Oak St Ste I",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971234245",
"country_code": "US",
"telephone_number": "503-430-0497",
"fax_number": "503-747-5985",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9155 SW Barnes Rd Ste 402",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972256631",
"country_code": "US",
"telephone_number": "503-292-7704",
"fax_number": "503-292-7046",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12550 SE 93rd Ave Ste 250",
"address_purpose": "LOCATION",
"city": "Clackamas",
"state": "OR",
"postal_code": "970156787",
"country_code": "US",
"telephone_number": "503-654-1153",
"fax_number": "503-654-7693",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "232 NE Norton Ln",
"address_purpose": "LOCATION",
"city": "McMinnville",
"state": "OR",
"postal_code": "971288470",
"country_code": "US",
"telephone_number": "503-434-1159",
"fax_number": "503-434-1190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8050 SW Warm Springs St Ste 150",
"address_purpose": "LOCATION",
"city": "Tualatin",
"state": "OR",
"postal_code": "970627422",
"country_code": "US",
"telephone_number": "503-692-7971",
"fax_number": "503-691-6837",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "925 Commercial St SE Ste 110",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973024173",
"country_code": "US",
"telephone_number": "503-967-6670",
"fax_number": "503-691-6837",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NORTHWEST RENAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-14",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A",
"authorized_official_last_name": "SMILEY",
"authorized_official_first_name": "CLAYTON",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "503-229-7976",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Northwest Recovery Services LLC (A Better Today)
- Northwest Regenerative Orthopedics
- Northwest Rehab Alliance (Nwra)
- Northwest Renal Clinic, Inc. (Northwest Dialysis Access Center)
- Northwest Renal Clinic, Inc.
- Northwest Renal Clinic, Inc.
- Northwest Renal Clinic, Inc.
- Northwest Renal Clinic, Inc.
- Northwest Rheumatology Associates, PC
- Northwest Spine Surgery LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.