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NPI #1104193283 in Milwaukie, Oregon

Provider Information

NPI Number
1104193283
Entity Type
Organization
Organization Name
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Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Nov 17, 2011
Last Updated
Oct 8, 2025

Practice Location

Address
11300 SE 23RD AVENUE
Address 2
MILWAUKIE HIGH SCHOOL HEALTH & WELLNESS CENTER
State
Oregon
ZIP Code
97222-7753
Phone
(503) 535-3861

Authorized Official

Name
HEATHER REPPETO
Title
EXECUTIVE DIRECTOR
Phone
(503) 535-3860

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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