Healthcare Provider Details

I. General information

NPI: 1053631747
Provider Name (Legal Business Name): MULTNOMAH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 NW 6TH AVE
PORTLAND OR
97209-3964
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 503-988-3666
  • Fax: 503-988-3015
Mailing address:
  • Phone: 503-988-3663
  • Fax: 503-988-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number StateOR

VIII. Authorized Official

Name: ANTOINETTE PAYNE
Title or Position: BUSINESS SERVICES DIRECTOR
Credential:
Phone: 971-325-6412