Healthcare Provider Details

I. General information

NPI: 1164385829
Provider Name (Legal Business Name): SUMMIT CARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 E BERKELEY ST
GLADSTONE OR
97027-2419
US

IV. Provider business mailing address

445 E BERKELEY ST
GLADSTONE OR
97027-2419
US

V. Phone/Fax

Practice location:
  • Phone: 769-447-7780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: EYERUSALEM WOLDU
Title or Position: DIRECTOR
Credential:
Phone: 769-447-7780