NPIMap

Organization Active NPI

Multnomah County

Doing business as Vaccine Depot

  • State or Local Public Health Clinic/Center
  • Portland, OR
National Provider Identifier
1023451044
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
MULTNOMAH COUNTY
Doing business as
Vaccine Depot
Practice address
619 NW 6TH Ave
Portland, OR 97209-3964
Phone
(503) 988-7468
Fax
(503) 988-3015
NPI assigned
Apr 9, 2013
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Antoinette Payne
Title
Business Services Director
Phone
(971) 325-6412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X NU Primary

Addresses

Primary practice location

619 NW 6TH Ave
Portland, OR 97209-3964

Mailing address

619 NW 6TH Ave
Portland, OR 97209-3964
Phone (503) 988-7468

Other identifiers 2

IdentifierTypeStateIssuer
096511MedicaidOR
022959MedicaidOR

Other names 1

  • Vaccine Depot Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Multicare Dental Dco89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1023451044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTNOMAH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "BUSINESS SERVICES DIRECTOR",
        "authorized_official_telephone_number": "971-325-6412"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096511",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vaccine Depot",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vaccine Depot",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.