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General NPI Number Information
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NPI Number | 1710629977
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Entity Type | Organization
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Legal Business Name | PDX ELITE CARE INC
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 707 SW WASHINGTON ST STE 1100
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City | PORTLAND
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State | OR
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Zip | 97205-3528
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Country | US
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Telephone | 503-444-2466
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Fax | 888-610-2910
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Provider Business Mailing Address
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Address Line | PO BOX 1942
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City | BEAVERTON
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State | OR
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Zip | 97075-1942
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Country | US
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Telephone | 503-619-7295
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Fax | 888-610-2910
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HELENA A LOPES-CULP
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Credential | CEO
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Telephone | 503-444-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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