Organization
CLACKAMAS COUNTY
Active
Other names
Beavercreek Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ED JOHNSON (CFO)
(503) 742-5325
Entity
Organization
Contact information
Practice address
110 BEAVERCREEK RD STE 100, OREGON CITY, OR 97045-4307
(503) 655-8471
(503) 655-8595
Mailing address
2051 KAEN RD, SUITE 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
Enumeration date
07/01/2006
Last updated
09/24/2019
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