OrganizationActive
Evgeny I Fedotov
NPI 1962412510 · Clinical Medical Laboratory · Portland, OR
Evgeny I Fedotov is a Clinical Medical Laboratory organization in Portland, OR (NPI 1962412510).
Provider details
- NPI number
- 1962412510
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Evgeny Fedotov, President(503) 252-5042
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6629 Ne 82nd Ave
Suite 203
Portland, OR 97220-1346
Phone: (503) 756-8159
Street-level locationGet directions
Mailing address
6629 Ne 82nd Ave
Portland, OR 97220-1346
Other names (DBA / former)
- Doing business as
- North West Clinical Laboratory
Registry dates
- Enumerated
- 2006-08-08
- Last updated
- 2020-08-22
Frequently asked questions
- What is Evgeny I Fedotov's NPI number?
- Evgeny I Fedotov's National Provider Identifier (NPI) is 1962412510, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evgeny I Fedotov?
- Evgeny I Fedotov is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Evgeny I Fedotov located?
- Evgeny I Fedotov's practice location on file with NPPES is 6629 Ne 82nd Ave, Portland, OR 97220-1346.
- What is Evgeny I Fedotov's phone number?
- The practice phone number listed in the NPPES registry for Evgeny I Fedotov is (503) 756-8159.
- Who is the authorized official for Evgeny I Fedotov?
- The authorized official listed on Evgeny I Fedotov's NPPES record is Evgeny Fedotov, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evgeny I Fedotov's NPI active?
- Yes — Evgeny I Fedotov's NPI (1962412510) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.