| Hepatitis C Program | |
|
619 Nw 6th Ave Portland OR 97209-3964 | |
| (503) 988-7468 | |
| (503) 988-3015 |
| Full Name | Hepatitis C Program |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 619 Nw 6th Ave, Portland, Oregon |
| Authorized Official Name and Position | Wendy Lear (BUSINESS SERVICES MANAGER) |
| Authorized Official Contact | 5039887511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hepatitis C Program 619 Nw 6th Ave Portland OR 97209-3964 Ph: (503) 988-7468 | Hepatitis C Program 619 Nw 6th Ave Portland OR 97209-3964 Ph: (503) 988-7468 |
| NPI Number | 1508388497 |
|---|---|
| Provider Enumeration Date | 07/12/2017 |
| Last Update Date | 03/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508388497 | NPI | - | NPPES |
| 096511 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oregon) | Primary |
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