Outside In | |
1132 Sw 13th Ave Portland OR 97205-1703 | |
(503) 535-3803 | |
(503) 223-6837 |
Full Name | Outside In |
---|---|
Speciality | Clinic/Center |
Location | 1132 Sw 13th Ave, Portland, Oregon |
Authorized Official Name and Position | Bill Bradford (FINANCE DIRECTOR) |
Authorized Official Contact | 5035353803 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Outside In 1132 Sw 13th Ave Portland OR 97205-1703 Ph: (503) 535-3803 | Outside In 1132 Sw 13th Ave Portland OR 97205-1703 Ph: (503) 535-3803 |
NPI Number | 1568401347 |
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Provider Enumeration Date | 06/06/2006 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 9638256662 |
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Medicare Enrollment ID | O20080401000752 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568401347 | NPI | - | NPPES |
181599 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oregon) | Primary |
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