Provider Demographics
NPI:1821399775
Name:CARE OREGON HEALTH CLINICS
Entity Type:Organization
Organization Name:CARE OREGON HEALTH CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMINGA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-305-6282
Mailing Address - Street 1:17070 SE MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-4960
Mailing Address - Country:US
Mailing Address - Phone:503-305-6282
Mailing Address - Fax:
Practice Address - Street 1:17070 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-4960
Practice Address - Country:US
Practice Address - Phone:503-305-6282
Practice Address - Fax:503-908-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health