Healthcare Provider Details

I. General information

NPI: 1891742300
Provider Name (Legal Business Name): RIGHT AT HOME MIDWIFERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 SE 76TH AVE
PORTLAND OR
97206-2446
US

IV. Provider business mailing address

3712 SE 76TH AVE
PORTLAND OR
97206-2446
US

V. Phone/Fax

Practice location:
  • Phone: 503-314-9186
  • Fax: 503-771-5501
Mailing address:
  • Phone: 503-314-9186
  • Fax: 503-771-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberDEM-LD-269194
License Number StateOR

VIII. Authorized Official

Name: MRS. ELEANOR ELIZABETH LEGARE
Title or Position: MEMBER
Credential: LDM, CPM
Phone: 503-314-9186