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General NPI Number Information
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NPI Number | 1821266099
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Entity Type | Organization
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Legal Business Name | DND HEALTHCARE, LLC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 10160 SW NIMBUS AVE BLDG F-4
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City | PORTLAND
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State | OR
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Zip | 97223-4338
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Country | US
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Telephone | 503-620-6011
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Fax | 503-620-6199
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Provider Business Mailing Address
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Address Line | 10160 SW NIMBUS AVE BLDG F-4
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City | PORTLAND
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State | OR
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Zip | 97223-4338
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Country | US
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Telephone | 503-620-6011
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Fax | 503-620-6199
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Authorized Official
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Title or Position | OWNER
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Name | MR. DENNIS DALE HARTVICKSON
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Credential |
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Telephone | 503-620-6011
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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 | 13-1394
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License Number State | OR
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