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General NPI Number Information
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NPI Number | 1033530035
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Entity Type | Organization
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Legal Business Name | NORTHWEST HOSPICE, LLC
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1000 S 16TH ST STE C
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City | PAYETTE
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State | ID
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Zip | 83661-3403
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Country | US
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Telephone | 208-642-9222
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Fax | 208-642-9224
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Provider Business Mailing Address
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Address Line | 25117 SW PARKWAY AVE STE F
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City | WILSONVILLE
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State | OR
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Zip | 97070-9697
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Country | US
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Telephone |
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Fax | 503-682-2132
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT THOMAS
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Credential | PT, MSPT
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Telephone | 503-783-2473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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