Healthcare Provider Details

I. General information

NPI: 1780481879
Provider Name (Legal Business Name): COMPASSIONATE INHOME CAREGIVING OF OREGON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52490 SE 2ND ST STE 140
SCAPPOOSE OR
97056-3641
US

IV. Provider business mailing address

52490 SE 2ND ST STE 140
SCAPPOOSE OR
97056-3641
US

V. Phone/Fax

Practice location:
  • Phone: 503-396-0830
  • Fax: 503-396-0830
Mailing address:
  • Phone: 503-396-0830
  • Fax: 503-396-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BETHANY L HULL
Title or Position: OWNER
Credential: RN
Phone: 503-396-0830