OUTSIDE IN NPI 1972124196

NPI Information

OUTSIDE IN is a federally qualified health center (fqhc) clinic center in Portland, OR. OUTSIDE IN NPI is 1972124196. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

16144 E BURNSIDE ST
PORTLAND, OR
ZIP 97233-520
Phone: (503) 535-3880
Fax: (503) 223-6837

The provider's authorized official is Bonnie Ross .
The authorized official title is Finance Director and has the following contact phone number (503) 535-3803.

The CLIA number assigned to this NPI record is 38D2208846 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/28/2020 and was last updated on 4/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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