<unavail> in Gresham, OR - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Gresham, Oregon. The current practice location for is 3505 Se 182nd Ave, Gresham, Oregon. For appointments, you can reach them via phone at (503) 988-5488. The mailing address for is 619 Nw 6th Ave Ste 500, Portland, Oregon and phone number is (503) 988-7468.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1912322074. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (503) 988-5488.

Contact Information


	3505 Se 182nd Ave Gresham OR 97030-5028
	(503) 988-5488
	(503) 988-5484

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	3505 Se 182nd Ave, Gresham, Oregon
Authorized Official Name and Position	Derrick Moten (INTERIM BUSINESS SERVICES DIRECTOR)
Authorized Official Contact	5039882966
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
619 Nw 6th Ave Ste 500 Portland OR 97209-3964 Ph: (503) 988-7468	3505 Se 182nd Ave Gresham OR 97030-5028 Ph: (503) 988-5488

NPI Details:

NPI Number	1912322074
Provider Enumeration Date	02/26/2014
Last Update Date	05/18/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	6608771787
Medicare Enrollment ID	O20240606000536

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912322074	NPI	-	NPPES
096511	Medicaid	OR
22959	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Gresham, OR

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- Medicare Primary Care in Gresham, OR