Organization
INDEPENCARE LLC
Active
Other names
Oasis Housing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL KRUMMENACKER (COO)
(503) 913-3693
Entity
Organization
Contact information
Practice address
9123 SE SAINT HELENS ST STE 100F, CLACKAMAS, OR 97015-6800
(503) 740-6449
Mailing address
10117 SE SUNNYSIDE RD # F1217, CLACKAMAS, OR 97015-7708
(503) 740-6449
(503) 771-2436
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
Primary
—
—
251B00000X
Case Management Agency
—
—
332U00000X
Home Delivered Meals
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Enumeration date
11/13/2024
Last updated
01/12/2025
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