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General NPI Number Information
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NPI Number | 1376973644
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Entity Type | Organization
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Legal Business Name | NIGHTINGALE HOME HEALTH, INC.
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 11707 NE GLISAN ST
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City | PORTLAND
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State | OR
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Zip | 97220-2141
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Country | US
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Telephone | 503-444-7605
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Fax | 503-334-4359
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Provider Business Mailing Address
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Address Line | 11707 NE GLISAN ST
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City | PORTLAND
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State | OR
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Zip | 97220-2141
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Country | US
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Telephone | 503-444-7605
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Fax | 503-334-4359
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Authorized Official
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Title or Position | ADMINISTRATOR/PRESIDENT
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Name | MELISSA SY
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Credential |
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Telephone | 503-444-7605
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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 |
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License Number State | OR
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