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Organization

COUNTY OF CLACKAMAS OFFICE OF COUNTY AUDITOR

Active
Other names
Gladstone Health Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
ED JOHNSON (CFO)
(503) 742-5325
Entity
Organization

Contact information

Practice address
18911 PORTLAND AVE, GLADSTONE, OR 97027-1630
(503) 850-4472
(503) 850-4473
Mailing address
2051 KAEN RD STE 367, OREGON CITY, OR 97045-4035
(503) 742-5300
(503) 655-8350

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022710
OR
05
031799
OR
05
131607
OR
Enumeration date
08/14/2012
Last updated
05/07/2026
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