Provider Demographics
NPI:1053859694
Name:VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Entity type:Organization
Organization Name:VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-214-1652
Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-0149
Mailing Address - Country:US
Mailing Address - Phone:503-597-4500
Mailing Address - Fax:503-597-4501
Practice Address - Street 1:333 SE 7TH AVE
Practice Address - Street 2:SUTIE 5500
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-597-4500
Practice Address - Fax:503-597-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)