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Organization
MULTNOMAH COUNTY
Active
Organization
MULTNOMAH COUNTY
Active
Parent organization
MULTNOMAH COUNTY
Other names
Multnomah County Detention Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MULTNOMAH COUNTY
Authorized official
MARK D LEWIS (FINANCE MANAGER)
(503) 988-7462
Entity
Organization
Contact information
Practice address
1120 SW 3RD AVE, DETENTION CENTER, PORTLAND, OR 97204-2828
(503) 988-3976
Mailing address
619 NW 6TH AVE FL 5, PORTLAND, OR 97209-3964
(503) 988-7468
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
Enumeration date
07/03/2019
Last updated
07/03/2019
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