| Franklin School Base | |
|
421 Sw Oak St Ste. 210 Portland OR 97204-1817 | |
| (503) 988-7468 | |
| (503) 988-3015 |
| Full Name | Franklin School Base |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 421 Sw Oak St, Portland, Oregon |
| Authorized Official Name and Position | Derrick Moten (INTERIM BUSINESS SERVICES DIRECTOR) |
| Authorized Official Contact | 5039882966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Franklin School Base 5405 Se Woodward St Portland OR 97206-2168 Ph: (503) 988-3370 | Franklin School Base 421 Sw Oak St Ste. 210 Portland OR 97204-1817 Ph: (503) 988-7468 |
| NPI Number | 1972919207 |
|---|---|
| Provider Enumeration Date | 07/08/2014 |
| Last Update Date | 05/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972919207 | NPI | - | NPPES |
| 22959 | Medicaid | OR | |
| 096511 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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