Healthcare Provider Details

I. General information

NPI: 1942125679
Provider Name (Legal Business Name): UNITY RTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 SW BUTNER CT
BEAVERTON OR
97005-0800
US

IV. Provider business mailing address

13100 SW BUTNER CT
BEAVERTON OR
97005-0800
US

V. Phone/Fax

Practice location:
  • Phone: 510-925-9011
  • Fax: 510-925-9011
Mailing address:
  • Phone:
  • Fax: 510-925-9011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YERUSALEM ETAFE
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 510-925-9011