Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Antico Medical LLC

Organization Internal Medicine Physician · NPI 1164344768

Antico Medical LLC is an Internal Medicine Physician in Portland, Oregon. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

75 NW Couch St Ste 300
Portland, OR 97209-4018
Phone: (614) 254-9761
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X

Record details

NPI number1164344768
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jida Hubana — President · (614) 254-9761
Other names Mel'S House Of Healing
NPI enumeratedJuly 27, 2026
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026
Mailing address75 Nw Couch St Ste 300, Portland, OR 97209-4018

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