MY OTHER ME; NPI #1801462080

Contact Information

MY OTHER ME

519 SW PARK AVE STE 304
PORTLAND, OR 97205-3204

Phone: 503-522-1446
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Gynecology	207VG0400X	16	Physician/Obstetrics & Gynecology

Indicates primary specialty

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NPI Profile & details for MY OTHER ME

NPI # 1801462080

LBN Legal business name MY OTHER ME

Authorized official MARY AFSARI-HOWARD - (FOUNDER/CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/28/2021

Last updated 03/11/2022 - About 4 years ago

Identifiers

Medicaid

5006254

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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