Healthcare Provider Details

I. General information

NPI: 1477973469
Provider Name (Legal Business Name): MULTNOMAH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NE 8TH ST RM 220
GRESHAM OR
97030-7317
US

IV. Provider business mailing address

619 NW 6TH AVE STE 500
PORTLAND OR
97209-3964
US

V. Phone/Fax

Practice location:
  • Phone: 503-988-7392
  • Fax: 503-988-6501
Mailing address:
  • Phone: 503-988-7468
  • Fax: 503-988-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: WENDY LEAR
Title or Position: DEPARTMENT DIRECTER
Credential:
Phone: 503-988-7511