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

Evgeny I Fedotov

Organization Clinical Medical Laboratory · NPI 1962412510

Evgeny I Fedotov is a Clinical Medical Laboratory in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2006.

Licensed in
OR
In the registry since
2006

Practice location Address checks out

6629 NE 82nd Ave Ste 203
Portland, OR 97220-1346
Phone: (503) 756-8159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X (OR)

Record details

NPI number1962412510
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Evgeny Fedotov — President · (503) 252-5042
Other names North West Clinical Laboratory
NPI enumeratedAugust 8, 2006
Last updated in NPPESAugust 22, 2020
Mailing address6629 Ne 82nd Ave, Suite 203, Portland, OR 97220-1346

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