Organization · Type 2 NPI

Prov Health Sys-Or Shared-Svs Div

Community Health Clinic/Center · Portland, OR

NPI number 1184918955 Active

Practice location

9340 SW Barnes Rd, Suite 200
Portland, OR 97225-6623

Fax (503) 216-2039

Specialties and licenses

Taxonomy	Code	License
Community Health Clinic/Center Primary	261QC1500X	None listed

Community Health Clinic/Center: Definition to come...

4 other providers at this address

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NPI record

NPI: 1184918955
Entity type: Organization (Type 2)
Issued: Jun 8, 2011
Last updated: Jun 8, 2011
Status: Active
Subpart: Yes of Providence Health & Services - Oregon

Other names

<unavail>
Providence Health Education · doing business as

Authorized official

Ms. Rebecca Marie Williams
Finance Director - Amb Services
(503) 893-6863

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1184918955

Prov Health Sys-Or Shared-Svs Div's National Provider Identifier is 1184918955, issued on Jun 8, 2011. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Portland, OR. The record was last updated on Jun 8, 2011.