Healthcare Provider Details

I. General information

NPI: 1346659695
Provider Name (Legal Business Name): RONALD MCDONALD HOUSE CHARITIES OF OREGON AND SOUTHWEST WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 N COMMERCIAL AVE
PORTLAND OR
97227-1631
US

IV. Provider business mailing address

2620 N COMMERCIAL AVE
PORTLAND OR
97227-1631
US

V. Phone/Fax

Practice location:
  • Phone: 971-230-6700
  • Fax: 971-230-6720
Mailing address:
  • Phone: 971-230-6700
  • Fax: 971-230-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: JACQUE LEE
Title or Position: FAMILY PLACEMENT MANAGER
Credential:
Phone: 971-832-1097