Healthcare Provider Details

I. General information

NPI: 1922209121
Provider Name (Legal Business Name): TRILLIUM FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 NE HWY 20
CORVALLIS OR
97330-9695
US

IV. Provider business mailing address

3415 SE POWELL BLVD
PORTLAND OR
97202-3371
US

V. Phone/Fax

Practice location:
  • Phone: 541-757-1852
  • Fax: 503-205-0193
Mailing address:
  • Phone: 503-205-4362
  • Fax: 503-205-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SUZY VENZKE
Title or Position: SR. BILLING MANAGER
Credential:
Phone: 503-205-4362