| Ohsu Child Development & Rehabilitation Center | |
|
707 Sw Gaines St Portland OR 97239-2901 | |
| (503) 494-8716 | |
| (503) 494-2721 |
| Full Name | Ohsu Child Development & Rehabilitation Center |
|---|---|
| Speciality | Clinic/center |
| Location | 707 Sw Gaines St, Portland, Oregon |
| Authorized Official Name and Position | Danny O. Jacobs (PRESIDENT) |
| Authorized Official Contact | 5034948252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohsu Child Development & Rehabilitation Center Po Box 3595 Portland OR 97208-3595 Ph: (503) 494-2709 | Ohsu Child Development & Rehabilitation Center 707 Sw Gaines St Portland OR 97239-2901 Ph: (503) 494-8716 |
| NPI Number | 1972688919 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 04/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972688919 | NPI | - | NPPES |
| 1023615 | Medicaid | WA | |
| 500751932 | Medicaid | OR | |
| 033472 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 333600000X | Pharmacy | (* (Not Available)) | Secondary |
Woodstock Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Se Woodstock Blvd, Portland, OR 97206 Phone: 503-236-1830 Fax: 503-236-1908 | |
Internal Medicine Consultants, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9585 Sw Washington Square Rd, Portland, OR 97223 Phone: 503-320-2121 Fax: 503-641-4158 | |
The Wellness Center Pdx Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1359 Ne 35th Avenue, Portland, OR 97232 Phone: 503-389-5545 | |
Providence Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5211 Ne Glisan St Bldg C, Portland, OR 97213 Phone: 503-215-6628 Fax: 503-215-6240 | |
Interstate Medical Office West Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3325 N Interstate Ave, Portland, OR 97227 Phone: 800-813-2000 Fax: 503-286-6879 | |
Jenna Halbert, Nd Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Ne Russell St Ste 207, Portland, OR 97212 Phone: 503-482-8301 | |
Cascadia Behavioral Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7511 Se Henry St, Portland, OR 97206 Phone: 503-771-6061 Fax: 503-771-7514 |