Basic Information
| Provider Information | |||||||||
| NPI: | 1851660955 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EL-BAKRI | ||||||||
| FirstName: | HUSAMEDDIN | ||||||||
| MiddleName: | RAWHI | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3158 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972083158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032156494 | ||||||||
| FaxNumber: | 7657410335 | ||||||||
| Practice Location | |||||||||
| Address1: | 18040 SW LOWER BOONES FERRY RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | TIGARD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972247259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032160624 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2011 | ||||||||
| LastUpdateDate: | 06/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD188949 | OR | N | Allopathic & Osteopathic Physicians | Family Medicine | 2083X0100X | MD188949 | OR | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 207Q00000X | 01047189A | IN | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.