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Organization

EMPOWERMENT CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL BRAXTON MSW, CADC III, QMHP (EXECUTIVE DIRECTOR)
(503) 676-3710
Entity
Organization

Contact information

Practice address
5257 NE MARTIN LUTHER KING JR BLVD STE 201&202, PORTLAND, OR 97211-3282
(503) 676-3710
(503) 430-5403
Mailing address
150 NE 3RD AVE STE A, HILLSBORO, OR 97124-3150
(503) 851-0059
(503) 430-5403

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2800
OR
101YM0800X
Mental Health Counselor
2800
OR
104100000X
Social Worker
OR
172V00000X
Community Health Worker
2800
OR
183500000X
Pharmacist
OR
251V00000X
Voluntary or Charitable Agency
OR
261QC1500X
Community Health Clinic/Center
Primary
OR
261QF0400X
Federally Qualified Health Center (FQHC)
OR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
2800
OR
261QP3300X
Pain Clinic/Center
2800
OR
363LC1500X
Community Health Nurse Practitioner
20105014NP
OR
363LP2300X
Primary Care Nurse Practitioner
20105014NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447490073
OR
05
50071465
OR
Enumeration date
02/23/2009
Last updated
06/11/2019
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