Provider Demographics
NPI:1912731944
Name:PACIFIC REFUGEE SUPPORT GROUP
Entity type:Organization
Organization Name:PACIFIC REFUGEE SUPPORT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JOSEPH HOKULEA
Authorized Official - Last Name:NEWBEGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-442-3010
Mailing Address - Street 1:10725 SW BARBUR BLVD STE 102B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8676
Mailing Address - Country:US
Mailing Address - Phone:503-442-3010
Mailing Address - Fax:
Practice Address - Street 1:10725 SW BARBUR BLVD STE 102B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-8676
Practice Address - Country:US
Practice Address - Phone:503-442-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health