Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health, State or Local |
261QP0905X | |||
Federally Qualified Health Center (FQHC) |
261QF0400X | B4[14] | Federally Qualified Health Center |
| NPI # | 1689799504 |
||||
| LBN Legal business name | CITY OF PORTLAND | ||||
| Authorized official | ALFERDO VERGARA - (DIRECTOR, PUBLIC HEALTH DIVISION) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/20/2007 | ||||
| Last updated | 07/11/2024 - More than a year ago | ||||
| Identifiers |
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