Healthcare Provider Details

I. General information

NPI: 1629972443
Provider Name (Legal Business Name): SUNSHINE RTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13525 SW 24TH ST
BEAVERTON OR
97008-5060
US

IV. Provider business mailing address

13525 SW 24TH ST
BEAVERTON OR
97008-5060
US

V. Phone/Fax

Practice location:
  • Phone: 503-330-4376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: SALIM NURI
Title or Position: OWNER/MANAGER
Credential:
Phone: 503-330-4376