MEDICARE: CONNECTED HEALTHCARE, 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	251G00000X	Community Based Hospice Care Agency	161065	OR

General Provider Information

NPI Number	:	1871972224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	7632 SW DURHAM RD STE 130
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97224-7584
Country	:	US
Telephone Number	:	503-261-8599
Fax Number	:	503-408-8922

Provider Business Practice Location Address
First Line	:	7632 SW DURHAM RD STE 130
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97224-7584
Country	:	US
Telephone Number	:	503-261-8599
Fax Number	:	503-408-8922

Authorized Official
Title or Position	:	SECRETARY
Name	:	AMBER TUELLER
Credential	:
Telephone Number	:	208-207-2726

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	02/07/2025

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