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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