| Benson Wellness Center | |
|
546 Ne 12th Ave Room 126 Portland OR 97232-2719 | |
| (503) 494-3900 | |
| Not Available |
| Full Name | Benson Wellness Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 546 Ne 12th Ave, Portland, Oregon |
| Authorized Official Name and Position | Cynthia Grueber (INTERIM SR VP, EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5034941450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benson Wellness Center 3930 Se Division St Portland OR 97202-1643 Ph: (503) 418-3900 | Benson Wellness Center 546 Ne 12th Ave Room 126 Portland OR 97232-2719 Ph: (503) 494-3900 |
| NPI Number | 1801254644 |
|---|---|
| Provider Enumeration Date | 02/08/2016 |
| Last Update Date | 02/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801254644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
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