OUTSIDE IN NPI 1104193283

NPI Information

NPI: 1104193283
Provider Name: OUTSIDE IN
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 38D2208843

Address:
11300 SE 23RD AVENUE
MILWAUKIE HIGH SCHOOL HEALTH & WELLNESS CENTER
MILWAUKIE, OR
ZIP 97222
Phone: (503) 535-3861
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OUTSIDE IN is a federally qualified health center (fqhc) clinic center in Milwaukie, OR. OUTSIDE IN NPI is 1104193283. The provider is registered as an organization entity type.

The provider's business location address is:

11300 SE 23RD AVENUE
MILWAUKIE HIGH SCHOOL HEALTH & WELLNESS CENTER
MILWAUKIE, OR
ZIP 97222-753
Phone: (503) 535-3861
Fax: (503) 223-6837

The provider's authorized official is Bill Bradford .
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 38D2208843 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2011 and was last updated on 11/17/2011.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	181599	MEDICAID	OREGON
2	381908	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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