Provider Demographics
NPI:1932301173
Name:MARION COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MARION COUNTY HEALTH DEPARTMENT
Other - Org Name:PSYCHIATRIC CRISIS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MENTAL HEALTH SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:GENNADYEVNA
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:503-585-4949
Mailing Address - Street 1:1073 OAK ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4018
Mailing Address - Country:US
Mailing Address - Phone:503-585-4949
Mailing Address - Fax:503-585-4965
Practice Address - Street 1:1073 OAK ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4018
Practice Address - Country:US
Practice Address - Phone:503-585-4949
Practice Address - Fax:503-585-4965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health