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NPI Code Detail

MEDICARE: FRIENDSHIP HEALTH CENTER, INC

MEDICARE: FRIENDSHIP HEALTH CENTER, INC
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
13140N1450XPediatric Skilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number : 1558427955
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRIENDSHIP HEALTH CENTER, INC
Provider Business Mailing Address
First Line : 3320 SE HOLGATE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-3459
Country : US
Telephone Number : 503-231-1411
Fax Number : 503-239-1170
Provider Business Practice Location Address
First Line : 3320 SE HOLGATE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-3459
Country : US
Telephone Number : 503-231-1411
Fax Number : 503-239-1170
Authorized Official
Title or Position : FISCAL OFFICER
Name : MRS. RUTH DEITZ
Credential :
Telephone Number : 503-872-1185
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/07/2021

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Directions to “FRIENDSHIP HEALTH CENTER, INC ” Practice Location

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