Organization
CENTRAL CITY CONCERN
Active
Other names
Old Town Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW B MENDENHALL MD (PRESIDENT & CEO)
(503) 294-1681
Entity
Organization
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 944-4465
(971) 271-6124
Mailing address
121 NW EVERETT ST, PORTLAND, OR 97209-4049
(503) 294-1681
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
RP0002607-CS
OR
Other
Enumeration date
07/16/2010
Last updated
04/09/2026
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