NPIMap

Organization Active NPI

Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1508904681
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MULTNOMAH COUNTY
Practice address
5530 NE 42ND Ave
Portland, OR 97218-1408
Phone
(503) 988-3991
NPI assigned
Feb 2, 2007
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
Deputy Dirtctor
Phone
(971) 325-6412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OR Primary
State or Local Public Health Clinic/Center 261QP0905X OR

Addresses

Primary practice location

5530 NE 42ND Ave
Portland, OR 97218-1408

Mailing address

619 NW 6TH Ave Ste 500
Portland, OR 97209-3964
Phone (503) 988-7468

Other practice location 1

6736 NE Killingsworth St
Portland, OR 97218-3338
Phone (503) 988-7462

Other identifiers 2

IdentifierTypeStateIssuer
096511MedicaidOR
022959MedicaidOR

Other names 2

  • Fernhill Health Center Doing business as
  • Multnomah County Health Dept, LaClinica Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031203000025 OR Part B Supplier - Clinic/Group Practice 6608771787 Receives reassigned benefits from 241 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Gresham, OR
O20090414000322 OR Part A Provider - Federally Qualified Health Center (FQHC) 6608771787 Practice locations: Portland, OR

Federally qualified health center certification: CCN 381833

Legal name
MULTNOMAH COUNTY
Doing business as
MULTNOMAH COUNTY HEALTH DEPARTMENT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 15, 1998
Last certification
Jan 15, 1998
Ownership / control type
Non-profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Dec 22, 1854 in OR
Enrollment address
5530 NE 42ND Ave
Portland, OR 97218-1408

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Multnomah County Health Dept-Pharmacy Admin89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Aline Blumenauer Individual W-2 Managing EmployeeFinance Manager Dec 1, 2023 50%
Derrick Moten Individual Corporate DirectorDeputy Director Dec 1, 2023 100%
Multnomah County Organization, Portland, OR 5% Or Greater Direct Ownership Interest Jan 15, 1998 100%
Sandra Pugh Individual W-2 Managing EmployeeBusiness Process Consultant Oct 3, 2017 50%
Rachael Banks Individual Corporate DirectorDirector Dec 1, 2023 100%

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Multnomah County Health DepartmentPortland, OR, CCN 381827 Federally qualified health center Other (100%) Jan 1, 2011
Multnomah County Health DepartmentPortland, OR, CCN 381828 Federally qualified health center Other (100%) Jan 15, 1998
Multnomah County Health DepartmentPortland, OR, CCN 381829 Federally qualified health center Other (100%) Oct 1, 2011
Multnomah County Health DepartmentPortland, OR, CCN 381830 Federally qualified health center Other (100%) Jan 1, 2015
Multnomah County Health DepartmentPortland, OR, CCN 381832 Federally qualified health center Other (100%) Oct 1, 2011
HIV Health ServicesPortland, OR, CCN 381925 Federally qualified health center Other (100%) Jan 15, 1998
Multnomah County Health DepartmentGresham, OR, CCN 381926 Federally qualified health center Operational/Managerial Control (100%)
Other		 Oct 21, 2011
Apr 1, 2019
Centennial School BaseGresham, OR, CCN 381030 Federally qualified health center Operational/Managerial Control (100%) Dec 1, 2023

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1508904681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE STE 500",
            "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": "5530 NE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181408",
            "telephone_number": "503-988-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6736 NE Killingsworth St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972183338",
            "country_code": "US",
            "telephone_number": "503-988-7462",
            "fax_number": "503-988-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MULTNOMAH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "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": "DEPUTY DIRTCTOR",
        "authorized_official_telephone_number": "971-325-6412"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "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": "Fernhill Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Multnomah County Health Dept, LaClinica",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Multnomah County Health Dept, LaClinica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.