Provider Demographics
NPI:1750408159
Name:OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES
Entity type:Organization
Organization Name:OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-693-4124
Mailing Address - Street 1:3150 NW 229TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7251
Mailing Address - Country:US
Mailing Address - Phone:503-693-4100
Mailing Address - Fax:503-693-5600
Practice Address - Street 1:3150 NW 229TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7251
Practice Address - Country:US
Practice Address - Phone:503-693-4100
Practice Address - Fax:503-693-5600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101185OtherMEDICARE ID - INDEPENDENT LAB
OR258202Medicaid