| Ohsu Health Family Medicine, East Portland | |
|
10101 Se Main St Ste 1001 Portland OR 97216-2456 | |
| (503) 346-6400 | |
| (503) 346-6330 |
| Full Name | Ohsu Health Family Medicine, East Portland |
|---|---|
| Speciality | Clinic/Center |
| Location | 10101 Se Main St Ste 1001, Portland, Oregon |
| Authorized Official Name and Position | Jennifer L Doll (SR. VP) |
| Authorized Official Contact | 5033074870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohsu Health Family Medicine, East Portland 3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 Ph: (503) 494-8311 | Ohsu Health Family Medicine, East Portland 10101 Se Main St Ste 1001 Portland OR 97216-2456 Ph: (503) 346-6400 |
| NPI Number | 1245093533 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 1759328842 |
|---|---|
| Medicare Enrollment ID | O20240610001025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245093533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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