MEDICARE: OUTSIDE IN

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	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

General Provider Information

NPI Number	:	1568401347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTSIDE IN

Provider Business Mailing Address
First Line	:	1132 SW 13TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-1703
Country	:	US
Telephone Number	:	503-535-3803
Fax Number	:	503-223-6837

Provider Business Practice Location Address
First Line	:	1132 SW 13TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-1703
Country	:	US
Telephone Number	:	503-535-3803
Fax Number	:	503-223-6837

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	HEATHER REPPETO
Credential	:
Telephone Number	:	503-535-3860

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	10/08/2025

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Directions to “OUTSIDE IN ” Practice Location

Language	Start Address	Practice Location

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