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NPI Code Detail

MEDICARE: PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.

MEDICARE: PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA0005XAmbulatory Family Planning FacilityOR
2261Q00000XClinic/Center
3261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000948000OTHERBLUE CROSS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053311860
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
Provider Business Mailing Address
First Line : 3727 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1112
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Provider Business Practice Location Address
First Line : 3727 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1112
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MS. STACY CROSS
Credential :
Telephone Number : 503-775-4931
Provider Enumeration Date : 07/22/2005
Last Update Date : 07/21/2022

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1063687895 — PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
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Directions to “PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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