| Outside In | |
|
1226 Sw 12th Ave Portland OR 97205-2029 | |
| (503) 535-3898 | |
| Not Available |
| Full Name | Outside In |
|---|---|
| Speciality | Clinic/Center |
| Location | 1226 Sw 12th Ave, Portland, Oregon |
| Authorized Official Name and Position | Heather Reppeto (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5035353860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Outside In 1132 Sw 13th Ave Portland OR 97205-1703 Ph: (503) 535-3800 | Outside In 1226 Sw 12th Ave Portland OR 97205-2029 Ph: (503) 535-3898 |
| NPI Number | 1477005619 |
|---|---|
| Provider Enumeration Date | 11/03/2016 |
| Last Update Date | 10/08/2025 |
| Medicare PECOS PAC ID | 9638256662 |
|---|---|
| Medicare Enrollment ID | O20170919002919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477005619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Clifford W Sells |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669488268 PECOS PAC ID: 2062580327 Enrollment ID: I20081014000448 |
| Provider Name | Jennifer M Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427289511 PECOS PAC ID: 3375794720 Enrollment ID: I20121112000180 |
| Provider Name | Carrie M Kent |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679839302 PECOS PAC ID: 0840519328 Enrollment ID: I20170727002122 |
| Provider Name | Isabelle T Trepiccione |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376961193 PECOS PAC ID: 3173840022 Enrollment ID: I20181217000675 |
| Provider Name | Flortasha Laray Pullom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043559529 PECOS PAC ID: 2769729540 Enrollment ID: I20190429002563 |
| Provider Name | Renell N Kumeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982247458 PECOS PAC ID: 3072941277 Enrollment ID: I20200323001819 |
| Provider Name | Sara E Wohlgemuth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699291708 PECOS PAC ID: 3274931191 Enrollment ID: I20211007001145 |
| Provider Name | Rachel K Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831625011 PECOS PAC ID: 6901176759 Enrollment ID: I20211026002758 |
| Provider Name | Monica N Ghali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326789744 PECOS PAC ID: 7618342593 Enrollment ID: I20230406000473 |
| Provider Name | Julia S Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518656032 PECOS PAC ID: 2062860547 Enrollment ID: I20231121003145 |
| Provider Name | Janet L Bardossi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285049031 PECOS PAC ID: 9335597947 Enrollment ID: I20240304002035 |
| Provider Name | Megan E Miranda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356999874 PECOS PAC ID: 4587191440 Enrollment ID: I20241217002647 |
Woodstock Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Se Woodstock Blvd, Portland, OR 97206 Phone: 503-236-1830 Fax: 503-236-1908 | |
Internal Medicine Consultants, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9585 Sw Washington Square Rd, Portland, OR 97223 Phone: 503-320-2121 Fax: 503-641-4158 | |
Medical Wellness Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1359 Ne 35th Avenue, Portland, OR 97232 Phone: 503-389-5545 | |
Providence Health & Services Oregon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5211 Ne Glisan St Bldg C, Portland, OR 97213 Phone: 503-215-6628 Fax: 503-215-6240 | |
Kaiser Foundation Health Plan Of The Northwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3325 N Interstate Ave, Portland, OR 97227 Phone: 800-813-2000 Fax: 503-286-6879 | |
Jenna Halbert, Nd Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Ne Russell St Ste 207, Portland, OR 97212 Phone: 503-482-8301 | |
Jen Conjerti Acupuncture Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4445 Ne Fremont St, Portland, OR 97213 Phone: 503-984-4748 |