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NPI Code Detail

MEDICARE: HOUSECALL PROVIDERS INC

MEDICARE: HOUSECALL PROVIDERS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care AgencyOR
2207QG0300XGeriatric Medicine (Family Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619915774
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSECALL PROVIDERS INC
Provider Business Mailing Address
First Line : 5100 SW MACADAM AVE
Second Line : SUITE 200
City : PORTLAND
State : OR
Zip : 97239-6102
Country : US
Telephone Number : 971-202-5500
Fax Number : 971-202-5555
Provider Business Practice Location Address
First Line : 5100 SW MACADAM AVE
Second Line : SUITE 200
City : PORTLAND
State : OR
Zip : 97239-6102
Country : US
Telephone Number : 971-202-5500
Fax Number : 971-202-5555
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : BENNETH ANN HUSTED
Credential : DO
Telephone Number : 970-202-5500
Provider Enumeration Date : 06/02/2006
Last Update Date : 01/24/2013

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Practice Location Address:
5100 SW MACADAM AVE , SUITE 200
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1972559409 — DR. BENNETH ANN HUSTED D.O.
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Practice Phone: 971-202-5500
Practice Fax: 971-202-5555
1245278126 — DR. LARA GARRETT M.D.
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5100 SW MACADAM AVE , SUITE 200
PORTLAND, OR
97239-6102
Practice Phone: 971-202-5500
Practice Fax: 971-202-5555
1912941667 — MRS. GAYLE MARGARET MORAN ADULT NURSE PRACTITI
Practice Location Address:
5100 SW MACADAM AVE , SUITE 200
PORTLAND, OR
97239-6102
Practice Phone: 971-202-5500
Practice Fax: 971-202-5555
1609811371 — ANNIE M HULME ANP
Practice Location Address:
5100 SW MACADAM AVE , SUITE 200
PORTLAND, OR
97239-6102
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1043247059 — VIRGINIA LEE HARRIS NP
Practice Location Address:
5100 SW MACADAM AVE , SUITE 200
PORTLAND, OR
97239-6102
Practice Phone: 971-202-5500
Practice Fax: 971-202-5555

Directions to “HOUSECALL PROVIDERS INC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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