MEDICARE: OREGON CARE RESIDENTIAL LLC

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1235063355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OREGON CARE RESIDENTIAL LLC

Provider Business Mailing Address
First Line	:	16441 NE FARGO CT
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-5521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16441 NE FARGO CT
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-5521
Country	:	US
Telephone Number	:	678-557-8309
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BUURE HASSEN
Credential	:
Telephone Number	:	678-557-8309

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “OREGON CARE RESIDENTIAL LLC ” Practice Location

Language	Start Address	Practice Location

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