Healthcare Provider Details

I. General information

NPI: 1518238815
Provider Name (Legal Business Name): NEIGHBORHOOD HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17175 SW TUALATIN VALLEY HWY SUITE B2
ALOHA OR
97006-4584
US

IV. Provider business mailing address

6420 SW MACADAM AVE STE 300
PORTLAND OR
97239-3519
US

V. Phone/Fax

Practice location:
  • Phone: 503-848-5861
  • Fax: 503-848-5863
Mailing address:
  • Phone: 503-941-3033
  • Fax: 503-384-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BLAIN WEST
Title or Position: CFO
Credential: CPA
Phone: 503-941-3033