Provider Demographics
NPI:1518238815
Name:NEIGHBORHOOD HEALTH CENTER
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BLAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:503-941-3033
Mailing Address - Street 1:6420 SW MACADAM AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3519
Mailing Address - Country:US
Mailing Address - Phone:503-941-3033
Mailing Address - Fax:503-384-2588
Practice Address - Street 1:17175 SW TUALATIN VALLEY HWY
Practice Address - Street 2:SUITE B2
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-4584
Practice Address - Country:US
Practice Address - Phone:503-848-5861
Practice Address - Fax:503-848-5863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-18
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty