Healthcare Provider Details

I. General information

NPI: 1063360782
Provider Name (Legal Business Name): SOLYANA RTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 NW 4TH ST
GRESHAM OR
97030-6915
US

IV. Provider business mailing address

965 NW 4TH ST
GRESHAM OR
97030-6915
US

V. Phone/Fax

Practice location:
  • Phone: 503-493-3198
  • Fax: 503-492-1384
Mailing address:
  • Phone: 503-493-3198
  • Fax: 503-492-1384

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: RAHEL B HAILE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-493-3198