MULTNOMAH COUNTY (NPI# 1083115612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083115612 |
| Entity Type | Organization |
| Organization Name | MULTNOMAH COUNTY |
| Other Organization Name | MID COUNTY DENTAL CLINIC |
| Practice Address |
12710 Se Division St Portland OR 97236-3134 |
| Mailing Address |
619 Nw 6th Ave Ste 500 Portland OR 97209-3964 |
| Practice Telephone | 5039883410 |
| Mailing Telephone | 5039887468 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2019-03-16 |
| Authorized Official Name | CAMMY GADDIS (FINANCE SPECIALIST) |
| Authorized Official Telephone | 5039887468 |
| Is Organization Subpart | Y |
| Parent Organization Name | MULNOMAH COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
OR | Ambulatory Health Care Facilities | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022959 | 05 |
| Other Name | Type Code |
|---|---|
| Mid County Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1649674862 | Multnomah County | Clinic/Center | 330 Se 11th Ave, Portland, OR 97214-1317 | 2014-10-17 |
| 1912322074 | Multnomah County | Clinic/Center | 3505 Se 182nd Ave, Gresham, OR 97030-5028 | 2014-02-26 |
| 1063725141 | Multnomah County | Clinic/Center | 1034 Se 130th Avenue, Portland, OR 97233 | 2010-07-19 |
| 1346480662 | Multnomah County | Clinic/Center | 6941 N Central St, Portland, OR 97203-6203 | 2009-02-26 |
| 1174763494 | Multnomah County | Clinic/Center | 12003 Ne Shaver St, Portland, OR 97220-1494 | 2009-02-26 |
| 1619117934 | Multnomah County | Clinic/Center | 5103 N Willis Blvd, Portland, OR 97203-3464 | 2009-02-26 |
| 1548400922 | Multnomah County | Clinic/Center | 10000 N Burr Ave, Portland, OR 97203-1714 | 2009-02-25 |
| 1730329111 | Multnomah County | Clinic/Center | 3400 Se 26th Ave, Portland, OR 97202-2130 | 2009-02-25 |
| 1588804975 | Multnomah County | Clinic/Center | 3905 Se 91st Ave, Portland, OR 97266-2815 | 2009-02-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MULTNOMAH COUNTY | 501 Se Hawthorne Blvd Ste 531, Portland, OR 97214-3587 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY 4-H ASSOCIATION | Osu Extension4h, 3880 Se 8th Ave, Portland, OR 97201 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY CORRECTIONS DEPUTIES ASSOCIATION | 9221 Sw Barbur Blvd Ste 301, Portland, OR 97219 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY DROP-BOX SERVICES, INC. | 8145 Ne Nicholas Ct, Hillsboro, OR 97124 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY EMPLOYEES UNION LOCAL 88 | 6025 E Burnside St, Portland, OR 97215 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY FARM BUREAU | 2000 Se Wilson Rd, Wood Village, OR 97060 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY HISTORICAL SOCIETY | 1200 Sw Park Avenue, Portland, OR 97205 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY MASTER GARDENERS ASSOCIATION | 200 Warner-milne Rd, Oregon City, OR 97045 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY MEDICAL SOCIETY | 7805 Sw 40th Ave, Portland, OR 97219 |
| Oregon Corporations, Companies and Business Names | MULTNOMAH COUNTY PROSECUTING ATTORNEY'S ASSOCIATION | 1021 Sw 4th Ave, Room 600, Portland, OR 97204 |
| Street Address |
12710 SE DIVISION ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298260 | Mary E Meadows | Family Medicine | 12710 Se Division St, Portland, OR 97236-3134 | 2006-06-03 |
| 1588281240 | Janet Trang Do | Pharmacist | 12710 Se Division St, Portland, OR 97236-3134 | 2020-06-29 |
| 1033759212 | Derrick Michael Jones | Physician Assistant | 12710 Se Division St, Portland, OR 97236-3134 | 2020-01-15 |
| 1447893383 | Krista Kaufman | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-10-23 |
| 1174170682 | Amy Samantha Peck | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-08-20 |
| 1841776598 | Stephen Lawrence Erwin | Dentist | 12710 Se Division St, Portland, OR 97236-3134 | 2018-07-16 |
| 1306394549 | Multnomah County Health Department | Clinic/Center | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-16 |
| 1952859555 | Neema Mohammad Nader | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-13 |
| 1447707625 | Margot Presley | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-06 |
| 1922485135 | Mary Caitlin Wells | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2015-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| 1144691098 | Central City Concern Inc | Clinic/Center | 2566 Ne Hoyt St, Portland, OR 97232-2323 | 2015-10-16 |
| 1295119386 | Central City Concern Inc | Clinic/Center | 12133 E. Burnside St, Portland, OR 97216-2344 | 2015-07-17 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.