Organization
EEA COMPANY
Active
Other names
Columbia Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA KAY VAN ORTWICK RN (ADMINISTRATOR/DNS)
(503) 543-7131
Entity
Organization
Contact information
Practice address
33910 E COLUMBIA AVE, SCAPPOOSE, OR 97056-3309
(503) 543-7131
(503) 543-5220
Mailing address
PO BOX 1068, SCAPPOOSE, OR 97056-1068
(503) 543-7131
(503) 543-5220
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1672725855
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800565
—
OR
Enumeration date
10/05/2009
Last updated
10/05/2009
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