Organization
TOUCHMARK AT FAIRWAY VILLAGE HOME HEALTH LLC
Active
Other names
Touchmark at Fairway Village Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN EUGENE PRYOR (EXECUTIVE VICE PRESIDENT)
(503) 646-5186
Entity
Organization
Contact information
Practice address
2909 SE VILLAGE LOOP, VANCOUVER, WA 98683-8108
(360) 254-2866
(360) 883-3103
Mailing address
5150 SW GRIFFITH DR, BEAVERTON, OR 97005-2935
(503) 646-5186
(503) 644-3568
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
011429
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D1049339
CLIA LICENSE
WA
Enumeration date
06/01/2006
Last updated
03/02/2021
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