ATCHISON DIALYSIS LLC NPI 1932568912

NPI Information

  • NPI: 1932568912
  • Provider Name: ATCHISON DIALYSIS, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: GRESHAM STATION DIALYSIS
  • CLIA Number: 38D2111163
  • Address: 878 NW BURNSIDE RD
    GRESHAM, OR
    ZIP 97030
  • Phone: (503) 465-1068

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NPI Details

ATCHISON DIALYSIS, LLC is an end-stage renal disease (esrd) treatment clinic center in Gresham, OR. ATCHISON DIALYSIS, LLC NPI is 1932568912. The provider is registered as an organization entity type.
The provider Is Doing Business As Gresham Station Dialysis.

The provider's business location address is:

878 NW BURNSIDE RD
GRESHAM, OR
ZIP 97030
Phone: (503) 465-1068
Fax: (503) 491-9229

The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 38D2111163 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/18/2016 and was last updated on 8/28/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11932568912MEDICAIDOREGON
217-0116OTHEROREGONSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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