Healthcare Provider Details

I. General information

NPI: 1801188347
Provider Name (Legal Business Name): ASH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 E POWELL BLVD
GRESHAM OR
97030-8003
US

IV. Provider business mailing address

1409 FRANKLIN ST SUITE 103
VANCOUVER WA
98660-2899
US

V. Phone/Fax

Practice location:
  • Phone: 503-465-9414
  • Fax:
Mailing address:
  • Phone: 360-213-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LAURA LINLEY
Title or Position: VP CLINICAL OPERATIONS
Credential: CRT,RPSGT
Phone: 815-978-3596