Provider Demographics
NPI:1407254576
Name:INTERLINK COE NETWORKS AND PROGRAMS
Entity Type:Organization
Organization Name:INTERLINK COE NETWORKS AND PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-640-2000
Mailing Address - Street 1:4660 NE BELKNAP CT
Mailing Address - Street 2:SUITE 209
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6467
Mailing Address - Country:US
Mailing Address - Phone:503-640-2000
Mailing Address - Fax:503-640-2028
Practice Address - Street 1:4660 NE BELKNAP CT
Practice Address - Street 2:SUITE 209
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6467
Practice Address - Country:US
Practice Address - Phone:503-640-2000
Practice Address - Fax:503-640-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08562302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization