Provider Demographics
NPI:1619796315
Name:MULTNOMAH COUNTY
Entity type:Organization
Organization Name:MULTNOMAH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-988-8291
Mailing Address - Street 1:209 SW 4TH AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1825
Mailing Address - Country:US
Mailing Address - Phone:971-347-6815
Mailing Address - Fax:
Practice Address - Street 1:209 SW 4TH AVE STE 520
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1825
Practice Address - Country:US
Practice Address - Phone:971-347-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTNOMAH COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty