Organization
PROVIDENCE WEST HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN B. ALLEN PT (SUPERVISOR)
(503) 574-9428
Entity
Organization
Contact information
Practice address
3601 SW MURRAY BLVD, STE. 40, BEAVERTON, OR 97005-2354
(503) 216-2001
Mailing address
3601 SW MURRAY BLVD, STE. 40, BEAVERTON, OR 97005-2354
(503) 216-2001
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2517
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2517
OREGON PHYSICAL THERAPY LICENSING BOARD
OR
Enumeration date
05/08/2008
Last updated
05/08/2008
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