NPIMap

Organization Active NPI

County of Clackamas Office of County Auditor

Doing business as Gladstone Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Gladstone, OR
National Provider Identifier
1275880866
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF CLACKAMAS OFFICE OF COUNTY AUDITOR
Doing business as
Gladstone Health Clinic
Practice address
18911 Portland Ave
Gladstone, OR 97027-1630
Phone
(503) 850-4472
Fax
(503) 850-4473
NPI assigned
Aug 14, 2012
Last updated
May 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Ed Johnson
Title
Cfo
Phone
(503) 742-5325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

18911 Portland Ave
Gladstone, OR 97027-1630

Mailing address

2051 Kaen Rd Ste 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Other identifiers 3

IdentifierTypeStateIssuer
031799MedicaidOR
022710MedicaidOR
131607MedicaidOR

Other names 1

  • Gladstone Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101026001528 OR Part A Provider - Federally Qualified Health Center (FQHC) 9537065560 1 other NPI on this enrollment
Practice locations: Gladstone, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275880866. Details of each certification follow.

Federally qualified health center certification: CCN 381923

Legal name
COUNTY OF CLACKAMAS OFFICE OF COUNTY AUDITOR
Doing business as
CLACKAMAS HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2010
Last certification
Nov 1, 2010
Ownership / control type
Non-profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
18911 Portland Ave
Gladstone, OR 97027-1630

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clackamas Cty MNTL HLTH15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

18911 Portland Ave
Gladstone, OR 97027
Phone (503) 722-6801

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Morgan Fetzer Individual W-2 Managing EmployeeCredentialing/Compliance Assistant Mar 1, 2015
Sarah Jacobson Individual W-2 Managing EmployeeOffice Manager Fiscal Dec 1, 2014 100%
County of Clackamas Office of County Auditor Organization, Oregon City, OR 5% Or Greater Direct Ownership Interest Jan 1, 2014 100%
Operational/Managerial Control Sep 1, 2010 100%
Adam Kearl Individual Corporate OfficerHealth Centers Cfo Oct 1, 2023

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Clackamas County

    dba Clackamas Health Centers - 1011 Courthouse Road

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1447507215

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Beavercreek Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1720017809

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Sandy Behavioral Health Center

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1841442001

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba DSB Behavioral Health

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1841443587

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Sunnyside Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Clackamas, OR
    • NPI 1891042487

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Sandy Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1043566847

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Hilltop Behavioral Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Milwaukie, OR
    • NPI 1245269315

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clackamas Health Centers - Sandy ClinicSandy, OR, CCN 381870 Federally qualified health center Operational/Managerial Control Dec 13, 2010
Clackamas Health CentersOregon City, OR, CCN 381820 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014
Lake Road Health CenterMilwaukie, OR, CCN 381922 Federally qualified health center Operational/Managerial Control (100%) Aug 28, 2006
Clackamas Health CentersClackamas, OR, CCN 381931 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014
Clackamas Health Centers - Sandy Health ClinicSandy, OR, CCN 381936 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 28, 2013
Clackamas Health CentersOregon City, OR, CCN 381944 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1990
Jan 1, 1990

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Clackamas County

    dba Clackamas Health Centers - 1011 Courthouse Road

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1447507215

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Beavercreek Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1720017809

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Sandy Behavioral Health Center

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1841442001

    Operational/Managerial Control

    CMS ownership
  • Clackamas County

    dba Sunnyside Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Clackamas, OR
    • NPI 1891042487

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Sandy Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1043566847

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Hilltop Behavioral Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Milwaukie, OR
    • NPI 1245269315

    Operational/Managerial Control

    CMS ownership

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Clackamas County

    dba Clackamas Health Centers - 1011 Courthouse Road

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1447507215

    County of Clackamas Office of County Auditor

    CMS ownership
  • Clackamas County

    dba Beavercreek Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Oregon City, OR
    • NPI 1720017809

    County of Clackamas Office of County Auditor

    CMS ownership
  • Clackamas County

    dba Sandy Behavioral Health Center

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1841442001

    County of Clackamas Office of County Auditor

    CMS ownership
  • Clackamas County

    dba Sunnyside Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Clackamas, OR
    • NPI 1891042487

    County of Clackamas Office of County Auditor

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Sandy Health Clinic

    • Federally Qualified Health Center (FQHC)
    • Sandy, OR
    • NPI 1043566847

    County of Clackamas Office of County Auditor

    CMS ownership
  • County of Clackamas Office of County Auditor

    dba Hilltop Behavioral Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Milwaukie, OR
    • NPI 1245269315

    County of Clackamas Office of County Auditor

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1275880866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD STE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-655-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18911 PORTLAND AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271630",
            "telephone_number": "503-850-4472",
            "fax_number": "503-850-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CLACKAMAS OFFICE OF COUNTY AUDITOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-742-5325"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031799",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022710",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131607",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gladstone Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gladstone Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gladstone, OR

Sources for this page

Verify at the official NPI Registry.