OrganizationActive
Multnomah County
NPI 1336640960 · Federally Qualified Health Center (FQHC) · Portland, OR
Provider details
- NPI number
- 1336640960
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Multnomah County
- Organization subpart
- Yes
- Authorized official
- Derrick Moten, Interim Business Services Director(503) 988-2966
Specialties & taxonomies
Ambulatory Health Care Facilities
- Dental Clinic/Center261QD0000X
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5329 Ne Mlk Jr Blvd
Portland, OR 97211-3237
Phone: (503) 988-3664
Street-level locationGet directions
Mailing address
619 Nw 6th Ave
Portland, OR 97209-3964
Other names (DBA / former)
- Doing business as
- Northeast Dental Clinic
Registry dates
- Enumerated
- 2018-02-28
- Last updated
- 2024-05-18
- Certified
- 2024-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.