Old Town Clinic

LBN: Central City Concern, Inc.
Old Town Clinic is an health care organization with primary practice located at 727 W Burnside St , Portland OR 97209-3514. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Central City Concern, Inc. can be contacted via phone (503) 228-4533, or through Mendenhall, Andrew via phone (503) 294-1681.

Contact Information

Primary practice address
727 W Burnside St Portland OR 97209-3514
Phone: (503) 228-4533
Fax: (503) 228-4618
Website:
Map and Directions
Authorized official contact:
Name: Mendenhall, Andrew Doctor of Medicine (MD)
Phone: (503) 294-1681

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1659661346
LBN Legal business name Central City Concern, Inc.
DBA Doing business as Old Town Clinic
Authorized official Mendenhall, Andrew Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 14th, 2011
Last updated May 24th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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