<unavail> in Portland, OR

is a primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Portland, Oregon. The current practice location for is 1401 Ne 68th Ave, Juvenile Justice Complex, Portland, Oregon. For appointments, you can reach them via phone at (503) 988-3663. 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 ) and its NPI number is 1760626006. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (503) 988-3663.

Contact Information


	1401 Ne 68th Ave Juvenile Justice Complex Portland OR 97213-4957
	(503) 988-3663
	(503) 988-3510

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/center - Federally Qualified Health Center (fqhc)
Location	1401 Ne 68th Ave, 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 and Practice Location

Mailing Address	Practice Location Address
619 Nw 6th Ave Ste 500 Portland OR 97209-3964 Ph: (503) 988-7468	1401 Ne 68th Ave Juvenile Justice Complex Portland OR 97213-4957 Ph: (503) 988-3663

NPI Details:

NPI Number	1760626006
Provider Enumeration Date	04/30/2009
Last Update Date	05/18/2024

Medical Identifiers

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

Identifier	Type	State	Issuer
1760626006	NPI	-	NPPES
022959	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 Portland, OR

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- Primary Care in Portland, OR