Healthcare Provider Details

I. General information

NPI: 1275454803
Provider Name (Legal Business Name): TRILLIUM MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 SW SCHOLLS FERRY RD STE 202
PORTLAND OR
97225-1692
US

IV. Provider business mailing address

PO BOX 2129
BEAVERTON OR
97075-2129
US

V. Phone/Fax

Practice location:
  • Phone: 503-893-2813
  • Fax: 503-388-3724
Mailing address:
  • Phone: 503-893-2813
  • Fax: 503-388-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: AMANDA M EDWARDS
Title or Position: MIDWIFE
Credential: CPM LDM
Phone: 503-893-2813