Provider Demographics
NPI:1942841176
Name:NEWELL, KIMIA IGHANI (PAC)
Entity type:Individual
Prefix:MRS
First Name:KIMIA
Middle Name:IGHANI
Last Name:NEWELL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:KIMIA
Other - Middle Name:
Other - Last Name:IGHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:409 NW SUNDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6578
Mailing Address - Country:US
Mailing Address - Phone:503-944-9081
Mailing Address - Fax:
Practice Address - Street 1:800 SW 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1999
Practice Address - Country:US
Practice Address - Phone:503-221-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-29
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant