Provider Demographics
NPI:1598706954
Name:JEWISH FAMILY & CHILD SERVICE
Entity Type:Organization
Organization Name:JEWISH FAMILY & CHILD SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-226-7079
Mailing Address - Street 1:1221 SW YAMHILL ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2110
Mailing Address - Country:US
Mailing Address - Phone:503-226-7079
Mailing Address - Fax:503-226-1130
Practice Address - Street 1:1221 SW YAMHILL ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2110
Practice Address - Country:US
Practice Address - Phone:503-226-7079
Practice Address - Fax:503-226-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR000WDBCQMedicare ID - Type Unspecified