CLACKAMAS COUNTY NPI 1891042487

NPI Information

NPI: 1891042487
Provider Name: CLACKAMAS COUNTY

Doing Business As: SUNNYSIDE HEALTH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 38D2047446

Address:
9775 SE SUNNYSIDE RD STE 200
CLACKAMAS, OR
ZIP 97015
Phone: (503) 794-3830
Get Directions

CLACKAMAS COUNTY is a federally qualified health center (fqhc) clinic center in Clackamas, OR. CLACKAMAS COUNTY NPI is 1891042487. The provider is registered as an organization entity type.
The provider Is Doing Business As Sunnyside Health Clinic.

The provider's business location address is:

9775 SE SUNNYSIDE RD STE 200
CLACKAMAS, OR
ZIP 97015-721
Phone: (503) 794-3830
Fax: (503) 794-3850

The provider's authorized official is Ed Johnson .
The authorized official title is Cfo and has the following contact phone number (503) 742-5325.

The CLIA number assigned to this NPI record is 38D2047446 - other - county jail with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2012 and was last updated on 9/24/2019.

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
1	022710	MEDICAID	OREGON
2	131607	MEDICAID	OREGON
3	031799	MEDICAID	OREGON
4	500653393	MEDICAID	OREGON

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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