| NPI | 1558523340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK MOTEN Interim Business Services Director 503-988-2966 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-05-18 |