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Contact Information

IMPACT NW
7211 SE 62ND AVE
PORTLAND, OR97206-7564
 Phone: 503-489-7034
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
 

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for IMPACT NW

NPI Number 1417495862
LBN Legal business name IMPACT NW
Authorized official AMANDA ADAMS - (LTK PROJECT COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2017
Last updated 03/17/2018 - About 8 years ago
Identifiers
OR Medicaid 500721499
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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