Provider Demographics
NPI:1821265364
Name:MULTNOMAH COUNTY HEALTH DEPT.-PHARMACY ADMIN.
Entity Type:Organization
Organization Name:MULTNOMAH COUNTY HEALTH DEPT.-PHARMACY ADMIN.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:KODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-988-3674
Mailing Address - Street 1:619 NW 6TH AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3964
Mailing Address - Country:US
Mailing Address - Phone:503-988-3674
Mailing Address - Fax:503-988-4345
Practice Address - Street 1:619 NW 6TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3964
Practice Address - Country:US
Practice Address - Phone:503-988-3674
Practice Address - Fax:503-988-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local