Provider Demographics
NPI:1528219326
Name:MARION COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MARION COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WIC PROGRAM SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:503-585-4947
Mailing Address - Street 1:3180 CENTER ST NE
Mailing Address - Street 2:SUITE 2360
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4532
Mailing Address - Country:US
Mailing Address - Phone:503-588-5057
Mailing Address - Fax:503-566-2971
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:SUITE 2360
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5057
Practice Address - Fax:503-566-2971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUBDIVISON OF THE STATE OF OREGON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR805533251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare