<unavail> in Portland, OR - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Portland, Oregon. The current practice location for is 3930 Se Division St, Portland, Oregon. For appointments, you can reach them via phone at (503) 418-3900. The mailing address for is 3181 Sw Sam Jackson Park Rd, Portland, Oregon and phone number is () -.

is licensed to practice in Oregon (license number 141008). The clinic also participates in the medicare program and its NPI number is 1477675148. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (503) 418-3900.

Contact Information


	3930 Se Division St Portland OR 97202-1643
	(503) 418-3900
	(503) 418-3938

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	3930 Se Division St, Portland, Oregon
Authorized Official Name and Position	Kelly Anne Smith (VP ENTERPRISE REVENUE CYCLE)
Authorized Official Contact	5034948760
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 Ph: () -	3930 Se Division St Portland OR 97202-1643 Ph: (503) 418-3900

NPI Details:

NPI Number	1477675148
Provider Enumeration Date	04/04/2007
Last Update Date	03/28/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	1759328842
Medicare Enrollment ID	O20050504000325

Medical Identifiers

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

Identifier	Type	State	Issuer
1477675148	NPI	-	NPPES
276321	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	141008 (Oregon)	Primary

Reviews and Comments

Clinic/Center in Portland, OR

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- Medicare Primary Care in Portland, OR