Organization
EVERGREEN OREGON HEALTHCARE PORTLAND, L.L.C.
Active
Parent organization
EMPRES OREGON HEALTHCARE, LLC
Other names
Portland Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES OREGON HEALTHCARE, LLC
Authorized official
BRENT WEIL (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
12441 SE STARK ST, PORTLAND, OR 97233-1053
(503) 255-7040
(503) 255-0555
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6736
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1676
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800000
—
OR
Enumeration date
05/05/2006
Last updated
01/30/2017
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