Provider Demographics
NPI:1194099234
Name:VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Entity type:Organization
Organization Name:VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-214-1652
Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-0149
Mailing Address - Country:US
Mailing Address - Phone:503-431-5775
Mailing Address - Fax:503-431-5776
Practice Address - Street 1:9000 SW DURHAM RD
Practice Address - Street 2:BLDG 710
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-5539
Practice Address - Country:US
Practice Address - Phone:503-431-5775
Practice Address - Fax:503-431-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)