Organization
TANDEM NORTHWEST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MCARTHUR (CFO)
(503) 428-5233
Entity
Organization
Contact information
Practice address
348 DENNIS LN N, KEIZER, OR 97303-5936
(503) 589-4901
Mailing address
101 PINE ST NE, SALEM, OR 97301-0728
(503) 589-4901
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10456
—
OR
Enumeration date
06/23/2020
Last updated
06/23/2020
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