| Franklin School Based | |
|
5405 Se Woodward St Portland OR 97206-2168 | |
| (503) 988-3370 | |
| (503) 988-6120 |
| Full Name | Franklin School Based |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5405 Se Woodward 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 Based 619 Nw 6th Ave Ste 500 Portland OR 97209-3964 Ph: (503) 988-7468 | Franklin School Based 5405 Se Woodward St Portland OR 97206-2168 Ph: (503) 988-3370 |
| NPI Number | 1942590930 |
|---|---|
| Provider Enumeration Date | 04/12/2011 |
| Last Update Date | 05/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942590930 | NPI | - | NPPES |
| 022959 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Oregon) | Primary |
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