=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871972224
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONNECTED HEALTHCARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2015
-----------------------------------------------------
Last Update Date | 02/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7632 SW DURHAM RD STE 130
-----------------------------------------------------
City | TIGARD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97224-7584
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-261-8599
-----------------------------------------------------
Fax | 503-408-8922
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7632 SW DURHAM RD STE 130
-----------------------------------------------------
City | TIGARD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97224-7584
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-261-8599
-----------------------------------------------------
Fax | 503-408-8922
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | AMBER TUELLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 208-207-2726
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 161065
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------