Healthcare Provider Details

I. General information

NPI: 1356060594
Provider Name (Legal Business Name): RWW HOME AND COMMUNITY REHAB SERVICES OREGON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 S MACADAM AVE STE 80B
PORTLAND OR
97239-4256
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 800-320-0681
  • Fax: 503-292-5208
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET S PEMBERTON
Title or Position: VICE PRESIDENT & MANAGER
Credential:
Phone: 800-866-0860