Healthcare Provider Details

I. General information

NPI: 1033530035
Provider Name (Legal Business Name): NORTHWEST HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S 16TH ST STE C
PAYETTE ID
83661-3403
US

IV. Provider business mailing address

25117 SW PARKWAY AVE STE F
WILSONVILLE OR
97070-9697
US

V. Phone/Fax

Practice location:
  • Phone: 208-642-9222
  • Fax: 208-642-9224
Mailing address:
  • Phone:
  • Fax: 503-682-2132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT THOMAS
Title or Position: PRESIDENT
Credential: PT, MSPT
Phone: 503-783-2473