Provider Demographics
NPI:1548702491
Name:CLACKAMAS COUNTY SOCIAL SERVICES DIV
Entity type:Organization
Organization Name:CLACKAMAS COUNTY SOCIAL SERVICES DIV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-650-5725
Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:P.O. BOX 2920
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-655-8640
Mailing Address - Fax:503-655-8889
Practice Address - Street 1:2051 KAEN RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4035
Practice Address - Country:US
Practice Address - Phone:503-655-8640
Practice Address - Fax:503-655-8889
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLACKAMAS, COUNTY OF
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR99974Medicaid