Healthcare Provider Details

I. General information

NPI: 1033489224
Provider Name (Legal Business Name): NEIGHBORHOOD HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 NW 3RD AVE
CANBY OR
97013-3640
US

IV. Provider business mailing address

7320 SW HUNZIKER RD STE 300
PORTLAND OR
97223-2302
US

V. Phone/Fax

Practice location:
  • Phone: 503-416-4547
  • Fax: 503-416-4553
Mailing address:
  • Phone: 503-941-3033
  • Fax: 503-747-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateOR

VIII. Authorized Official

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