Healthcare Provider Details

I. General information

NPI: 1306720644
Provider Name (Legal Business Name): ABRAHAM ADARE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4711 SE 1ST TER
GRESHAM OR
97080-2007
US

IV. Provider business mailing address

16782 NE SCHUYLER CT
PORTLAND OR
97230-6092
US

V. Phone/Fax

Practice location:
  • Phone: 971-335-8240
  • Fax:
Mailing address:
  • Phone: 971-335-8240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: