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Organization
OREGON DEPARTMENT OF CORRECTIONS
Active
Organization
OREGON DEPARTMENT OF CORRECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LINN REY MENZIE LCSW (BHS PROGRAM MANAGER)
(503) 280-6646
Entity
Organization
Contact information
Practice address
17734 SW SHASTA TRL, TUALATIN, OR 97062-8455
(503) 691-1718
Mailing address
17734 SW SHASTA TRL, TUALATIN, OR 97062-8455
(503) 691-1718
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
L4861
OR
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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