MEDICARE: MARQUIS COMPANIES II, 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
1	310400000X	Assisted Living Facility		OR

General Provider Information

NPI Number	:	1811371859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARQUIS COMPANIES II, INC

Provider Business Mailing Address
First Line	:	4560 SE INTERNATIONAL WAY STE 100
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-4628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3336 19TH AVE
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1913
Country	:	US
Telephone Number	:	503-359-1129
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE CONTROLLER
Name	:	STACI TONE
Credential	:
Telephone Number	:	971-206-5100

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	07/18/2015

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