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General NPI Number Information
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NPI Number | 1003969791
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Entity Type | Organization
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Legal Business Name | HOMEWATCH CAREGIVERS
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3803 SE GLADSTONE ST
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City | PORTLAND
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State | OR
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Zip | 97202-3245
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Country | US
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Telephone | 503-254-8343
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Fax | 503-281-4612
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Provider Business Mailing Address
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Address Line | 3803 SE GLADSTONE ST
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City | PORTLAND
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State | OR
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Zip | 97202-3245
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Country | US
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Telephone | 503-254-8343
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Fax | 503-281-4612
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LEANN REYNOLDS
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Credential | DIRECTOR
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Telephone | 503-254-8343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 71500705952155
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License Number State | OR
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