| Mobile Service Unit 1 | |
|
313 Nw 3rd Ave Suite 1 Portland OR 97209 | |
| (971) 998-8702 | |
| (971) 269-2596 |
| Full Name | Mobile Service Unit 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 313 Nw 3rd Ave, Portland, Oregon |
| Authorized Official Name and Position | Andrew B Mendenhall (PRESIDENT & CEO) |
| Authorized Official Contact | 4135842173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Service Unit 1 232 Nw 6th Ave Portland OR 97209-3609 Ph: (503) 294-1681 | Mobile Service Unit 1 313 Nw 3rd Ave Suite 1 Portland OR 97209 Ph: (971) 998-8702 |
| NPI Number | 1649036880 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 02/26/2024 |
| Medicare PECOS PAC ID | 6103803259 |
|---|---|
| Medicare Enrollment ID | O20240313003110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649036880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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