Organization
RUSSELLVILLE III LLC
Active
Other names
Russellville Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYN RASAR (VP OPERATIONS)
(206) 436-7827
Entity
Organization
Contact information
Practice address
23 SE 103RD AVE, PORTLAND, OR 97216
(503) 254-5900
Mailing address
23 SE 103RD AVE, PORTLAND, OR 97216
(503) 254-5900
(503) 255-7098
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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