Organization
MULTNOMAH COUNTY
Active
Other names
Franklin School Base
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK MOTEN (INTERIM BUSINESS SERVICES DIRECTOR)
(503) 988-2966
Entity
Organization
Contact information
Practice address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015
Mailing address
5405 SE WOODWARD ST, PORTLAND, OR 97206-2168
(503) 988-3370
(503) 988-6420
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096511
—
OR
05
—
22959
—
OR
Enumeration date
07/08/2014
Last updated
05/18/2024
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