MULTNOMAH COUNTY

NPI # 

Practice Address:

12425 Ne Glisan St

Portland, OR, 97230-2144

Practice Phone:

503-988-0577

Practice Fax:

503-988-9388

License State:

OR

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Public Health, State or Local

Taxonomy Code:

261QP0905X