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Organization
SIGNATURE COASTAL, LLC
Active
Organization
SIGNATURE COASTAL, LLC
Active
Other names
Signature Healthcare at Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KOFSTAD NP (PRESIDENT)
(971) 224-2033
Entity
Organization
Contact information
Practice address
798 SE HIGHWAY 101, LINCOLN CITY, OR 97367-2715
(541) 264-7823
Mailing address
7632 SW DURHAM RD STE 105, TIGARD, OR 97224-7597
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500776028
—
OR
Enumeration date
01/23/2019
Last updated
11/13/2025
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