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NPI Code Detail

MEDICARE: MULTNOMAH COUNTY

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
1261QP0905XState or Local Public Health Clinic/CenterOR
2261QF0400XFederally Qualified Health Center (FQHC)OR

Other Identifiers

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

General Provider Information

NPI Number : 1609914787
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 : 9000 N LOMBARD ST
Second Line :
City : PORTLAND
State : OR
Zip : 97203-3006
Country : US
Telephone Number : 503-988-7462
Fax Number : 503-988-5305
Authorized Official
Title or Position : INTERIM BUSINESS SERVICES DIRECTOR
Name : DERRICK MOTEN
Credential :
Telephone Number : 503-988-2966
Provider Enumeration Date : 02/02/2007
Last Update Date : 05/18/2024

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Directions to “MULTNOMAH COUNTY ” Practice Location

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