MEDICARE: WESTERN HEALTH RESOURCES

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	251E00000X	Home Health Agency	394343	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1285663468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN HEALTH RESOURCES

Provider Business Mailing Address
First Line	:	2100 DOUGLAS BLVD
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-3804
Country	:	US
Telephone Number	:	916-781-4772
Fax Number	:	916-774-3341

Provider Business Practice Location Address
First Line	:	5835 NE 122ND AVE
Second Line	:	SUITE 155
City	:	PORTLAND
State	:	OR
Zip	:	97230-1057
Country	:	US
Telephone Number	:	503-251-6303
Fax Number	:	503-251-6265

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. BILL G WIEDEMANN
Credential	:
Telephone Number	:	916-781-4772

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	08/22/2020

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Directions to “WESTERN HEALTH RESOURCES ” Practice Location

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