Organization
TRINITY MISSION HEALTH & REHAB OF PORTLAND, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ULLERY (PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
10435 SE CORA ST, PORTLAND, OR 97266-2331
(503) 760-1737
(503) 761-1582
Mailing address
10435 SE CORA ST, PORTLAND, OR 97266-2331
(503) 760-1737
(503) 761-1582
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N/A
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800750
—
OR
Enumeration date
05/11/2006
Last updated
08/10/2007
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