# LEGACY MERIDIAN PARK PEDIATRIC REHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801122593
- **Authorized official:** SARAH JENSEN SLP (VP FINANCE)
- **Authorized official phone:** (503) 415-5145

## Contact information

- **Practice address:** 19250 SW 65TH AVE STE 125, TUALATIN, OR 97062-7745
- **Practice address phone:** (503) 413-4505
- **Mailing address:** PO BOX 6689, PORTLAND, OR 97228-6689
- **Mailing address phone:** (503) 413-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 283XC2000X | Children's Rehabilitation Hospital | 930618915 | OR | Yes |

## Other

- **Enumeration date:** 10/30/2009
- **Last updated:** 01/20/2026