Organization
HDE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN BRADETICH (STAFFING COORDINATOR)
(503) 686-9079
Entity
Organization
Contact information
Practice address
12655 SW CENTER ST STE 450, BEAVERTON, OR 97005-4726
(503) 686-9079
Mailing address
12655 SW CENTER ST STE 450, BEAVERTON, OR 97005-4726
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2229
OR
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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