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Organization
PRO-STEP REHAB
Active
Organization
PRO-STEP REHAB
Active
Parent organization
EXTENDICARE
Other names
Care Center East
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXTENDICARE
Authorized official
CHRISTINE M VAN OSDOL OT (FACILITY REHAB COORDINATOR)
(503) 253-1181
Entity
Organization
Contact information
Practice address
11325 NE WEIDLER ST, PORTLAND, OR 97220-1950
(503) 253-1181
(503) 253-1871
Mailing address
11325 NE WEIDLER ST, PORTLAND, OR 97220-1950
(503) 253-1181
(503) 253-1871
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
316072
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
316072
OCCUPATIONAL THERAPY LICENSE
OR
Enumeration date
10/29/2013
Last updated
10/29/2013
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