Portland Impact, Inc

LBN: Impact Nw
Portland Impact, Inc is an health care organization with primary practice located at 7211 Se 62Nd Ave , Portland OR 97206. The organization recently has 2 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Community/Behavioral Health. Agencies / Case Management is the primary health care specialty. Impact Nw can be contacted via phone (503) 721-6776, or through Adams, Amanda Lee via phone (541) 227-8888.

Contact Information

Primary practice address
7211 Se 62Nd Ave Portland OR 97206
Phone: (503) 721-6776
Fax: (971) 254-8969
Website:
Map and Directions
Authorized official contact:
Name: Adams, Amanda Lee
Phone: (541) 227-8888

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1053624387
LBN Legal business name Impact Nw
DBA Doing business as Portland Impact, Inc
Authorized official Adams, Amanda Lee
Entity Organization
Organization subpart 1 No
Enumeration date Jul 15th, 2010
Last updated Aug 17th, 2017 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1053624387 NPPES
Oregon MEDICAID 500721499

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