=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538076963
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WELBEHEALTH OREGON PACE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3510 LANCASTER DRIVE NE
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-555-9980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 440 N BARRANCA AVE # 4051
-----------------------------------------------------
City | COVINA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91723-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP, OPERATIONS
-----------------------------------------------------
Name | JENNIFER GEORGE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-765-3544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251T00000X
-----------------------------------------------------
Taxonomy Name | PACE Provider Organization
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------