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Organization

MULTNOMAH COUNTY

Active
Parent organization
COUNTY OF MULTNOMAH
Organization subpart
Yes

Provider details

NPI number
Legal business name
COUNTY OF MULTNOMAH
Authorized official
DERRICK MOTEN (INTERIM BUSINESS SERVICES DIRECTOR)
(503) 988-2966
Entity
Organization

Contact information

Practice address
5210 N KERBY AVE, PORTLAND, OR 97217-2656
(503) 988-3360
(503) 988-5780
Mailing address
619 NW 6TH AVE STE 500, PORTLAND, OR 97209-3964
(503) 988-7468
(503) 988-3015

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022959
OR
Enumeration date
02/24/2009
Last updated
05/18/2024
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