Organization
DEUT 1111
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA ALFONSO (OWNER)
(971) 762-3132
Entity
Organization
Contact information
Practice address
10478 SW MOUNT ADAMS DR, BEAVERTON, OR 97007-8379
(971) 762-3132
(971) 762-3132
Mailing address
10478 SW MOUNT ADAMS DR, BEAVERTON, OR 97007-8379
(971) 762-3132
(971) 762-3132
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/25/2025
Last updated
11/25/2025
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