Provider Demographics
NPI:1669724779
Name:MULTNOMAH COUNTY - AGING AND DISABILITY SERVICES DIVISION
Entity type:Organization
Organization Name:MULTNOMAH COUNTY - AGING AND DISABILITY SERVICES DIVISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-988-3770
Mailing Address - Street 1:421 SW OAK ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1817
Mailing Address - Country:US
Mailing Address - Phone:503-988-3620
Mailing Address - Fax:503-988-3656
Practice Address - Street 1:421 SW OAK ST
Practice Address - Street 2:SUITE 510
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1817
Practice Address - Country:US
Practice Address - Phone:503-988-3620
Practice Address - Fax:503-988-3656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTNOMAH COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management