Organization
SIGNATURE COASTAL, LLC
Active
Other names
Signature Healthcare at Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KOFSTAD NP (PRESIDENT)
(971) 224-2033
Entity
Organization
Contact information
Practice address
798 SE HIGHWAY 101, LINCOLN CITY, OR 97367-2715
(541) 264-7823
Mailing address
7632 SW DURHAM RD STE 105, TIGARD, OR 97224-7597
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500776028
—
OR
Enumeration date
01/23/2019
Last updated
11/13/2025
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