MEDICARE: NEIGHBORHOOD HEALTH CENTER

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	1223G0001X	General Practice Dentistry
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

General Provider Information

NPI Number	:	1750729257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD HEALTH CENTER

Provider Business Mailing Address
First Line	:	7320 SW HUNZIKER RD STE 300
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-2302
Country	:	US
Telephone Number	:	503-941-3033
Fax Number	:	503-747-7013

Provider Business Practice Location Address
First Line	:	3300 SE DWYER DR STE 302
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-6548
Country	:	US
Telephone Number	:	503-850-4479
Fax Number	:	503-850-4481

Authorized Official
Title or Position	:	CFO
Name	:	BLAIN WEST
Credential	:	CPA
Telephone Number	:	503-941-3033

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	11/25/2019

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Directions to “NEIGHBORHOOD HEALTH CENTER ” Practice Location

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