Organization
EVERGREEN OREGON HEALTHCARE CORVALLIS, L.L.C.
Active
Parent organization
EVERGREEN OREGON HEALTHCARE, L.L.C.
Other names
Conifer House
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN OREGON HEALTHCARE, L.L.C.
Authorized official
DALE L PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
145 NE CONIFER BLVD, CORVALLIS, OR 97330-4105
(541) 757-2444
(541) 757-8621
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1912975489
OR
Other
Enumeration date
09/24/2010
Last updated
06/02/2011
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