Organization
LAURELHURST VILLAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA LEE WALOROFF RN MS (CEO)
(503) 595-2810
Entity
Organization
Contact information
Practice address
3060 SE STARK ST, PORTLAND, OR 97214-3053
(503) 535-4700
(503) 797-6702
Mailing address
3060 SE STARK ST, PORTLAND, OR 97214-3053
(503) 535-4700
(503) 797-6702
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
OR
313M00000X
Nursing Facility/Intermediate Care Facility
—
OR
314000000X
Skilled Nursing Facility
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800093
—
OR
Enumeration date
06/03/2006
Last updated
09/11/2025
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