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NPI Code Detail

MEDICARE: TRILLIUM FAMILY SERVICES, INC.

MEDICARE: TRILLIUM FAMILY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2323P00000XPsychiatric Residential Treatment FacilityOR
3322D00000XEmotionally Disturbed Childrens' Residential Treatment FacilityOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093873382
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRILLIUM FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : 3415 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-3371
Country : US
Telephone Number : 503-234-9591
Fax Number : 503-205-0193
Provider Business Practice Location Address
First Line : 3415 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-3371
Country : US
Telephone Number : 503-234-9591
Fax Number : 503-205-0193
Authorized Official
Title or Position : BILLING MANAGER
Name : SUZY VENZKE
Credential :
Telephone Number : 503-205-4362
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/22/2025

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Directions to “TRILLIUM FAMILY SERVICES, INC. ” Practice Location

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