MEDICARE: MULTNOMAH COUNTY

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
1	261QP0905X	State or Local Public Health Clinic/Center		OR
2	261QF0400X	Federally Qualified Health Center (FQHC)		OR

Other Identifiers

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

General Provider Information

NPI Number	:	1427196500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTNOMAH COUNTY

Provider Business Mailing Address
First Line	:	619 NW 6TH AVE STE 500
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-3964
Country	:	US
Telephone Number	:	503-988-7468
Fax Number	:	503-988-3015

Provider Business Practice Location Address
First Line	:	5329 NE MLK JR BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-3237
Country	:	US
Telephone Number	:	503-988-7462
Fax Number	:	503-988-3015

Authorized Official
Title or Position	:	BUSINESS SERVICES MANAGER
Name	:	MS. WENDY LEAR
Credential	:
Telephone Number	:	503-988-7462

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	02/03/2020

Similar Medicare Providers

1639911076 — JOURNEY LYNN ARTIS
Practice Location Address:

5329 NE MARTIN LUTHER KING BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-5558
Practice Fax:

1699777482 — EVELYN A. P. CURIOSO
Practice Location Address:

5329 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-5183
Practice Fax: 503-988-5182

1528073319 — MULTNOMAH COUNTY
Practice Location Address:

5329 NE MARTIN L KING FL JRBLVD2
PORTLAND, OR
97211-3237

Practice Phone: 503-988-3634
Practice Fax: 503-988-4345

1801995683 — DR. MARYANN MCCORMICK DMD
Practice Location Address:

5329 NE M L KING BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-3664
Practice Fax:

1982783841 — NHATHI THI HOANG DMD
Practice Location Address:

5329 NE M L KING BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-3664
Practice Fax: 503-988-5700

1548338684 — DR. JERRY WAYNE LEONARD, JR. D.M.D.
Practice Location Address:

5329 NE M L KING BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-3664
Practice Fax:

1306994553 — DR. KY SAN PHARM.D.
Practice Location Address:

5329 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97211-3237

Practice Phone: 503-988-8264
Practice Fax:

Directions to “MULTNOMAH COUNTY ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.