Provider Demographics
NPI:1124870779
Name:PORTLAND OPPORTUNITIES INDUSTRIALIZATION CENTER, INC.
Entity type:Organization
Organization Name:PORTLAND OPPORTUNITIES INDUSTRIALIZATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BUSINESS OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STILWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-929-7301
Mailing Address - Street 1:9828 E BURNSIDE ST STE 225
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2364
Mailing Address - Country:US
Mailing Address - Phone:503-797-7222
Mailing Address - Fax:
Practice Address - Street 1:9828 E BURNSIDE ST STE 225
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2364
Practice Address - Country:US
Practice Address - Phone:503-797-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty