MEDICARE: CARING FOR COLUMBIA GORGE LLC

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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1740048396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING FOR COLUMBIA GORGE LLC

Provider Business Mailing Address
First Line	:	2659 SW 4TH ST STE 102
Second Line	:
City	:	REDMOND
State	:	OR
Zip	:	97756-6406
Country	:	US
Telephone Number	:	541-238-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 PORTWAY AVE # 300
Second Line	:
City	:	HOOD RIVER
State	:	OR
Zip	:	97031-1182
Country	:	US
Telephone Number	:	541-716-4471
Fax Number	:	866-286-4280

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	KATHRYN R PAULINO
Credential	:
Telephone Number	:	541-238-7500

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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