| Outside In | |
|
1132 Sw 13th Ave Portland OR 97205-1703 | |
| (503) 535-3842 | |
| (503) 535-3842 |
| Full Name | Outside In |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1132 Sw 13th Ave, Portland, Oregon |
| Authorized Official Name and Position | Amy Dawn Moore (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 5035353842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outside In 1132 Sw 13th Ave Portland OR 97205-1703 Ph: (503) 535-3842 | Outside In 1132 Sw 13th Ave Portland OR 97205-1703 Ph: (503) 535-3842 |
| NPI Number | 1811404353 |
|---|---|
| Provider Enumeration Date | 01/05/2018 |
| Last Update Date | 01/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811404353 | NPI | - | NPPES |
| 181599 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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