Organization
MULTNOMAH COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENDY LEAR (BUSINESS SERVICES MANAGER)
(503) 988-3663
Entity
Organization
Contact information
Practice address
3653 SE 34TH AVE, PORTLAND, OR 97202-3034
(503) 988-3663
Mailing address
619 NW 6TH AVE STE 500, PORTLAND, OR 97209-3964
(503) 988-7468
(503) 988-4098
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
Enumeration date
07/19/2010
Last updated
03/15/2019
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