Provider Demographics
NPI:1124043856
Name:CLATSOP COUNTY
Entity Type:Organization
Organization Name:CLATSOP COUNTY
Other - Org Name:CLATSOP COUNTY HEALTH & HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-338-3600
Mailing Address - Street 1:820 EXCHANGE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-4609
Mailing Address - Country:US
Mailing Address - Phone:503-338-3600
Mailing Address - Fax:503-325-8678
Practice Address - Street 1:820 EXCHANGE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4609
Practice Address - Country:US
Practice Address - Phone:503-338-3600
Practice Address - Fax:503-325-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR096560Medicaid
ORR0000JHJSFMedicare PIN