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CH10112E COUNTY OF MULTNOMAH (Terminated)
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Main Details
Name
COUNTY OF MULTNOMAH
Subdivision Name
WESTSIDE HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002163
340B ID
CH10112E
Grant Number
H80CS00149
Additional Details
Current Program Status
Terminated
Registration Date
4/1/1995
Participating Start Date
4/1/1995
Participating Approval Date
4/1/1995
Last Recertification Date
2/12/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
WENDY LEAR, Administrator
(503) 988-7511
Primary Contact
Multnomah County
CAMMY GADDIS, Finance Specialist
(503) 988-7468
Addresses
Street Address
426 SW STARK STREET FL 5
PORTLAND, OR 97204-2347
Billing Address
Westside Health Center
421 SW Oak St.
Ste. 210
Portland, OR 97204
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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