MEDICARE: ELORE HEALTH SYSTEM 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1891651931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELORE HEALTH SYSTEM LLC

Provider Business Mailing Address
First Line	:	35 NE WEIDLER ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-1118
Country	:	US
Telephone Number	:	971-202-2442
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 NE WEIDLER ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-1118
Country	:	US
Telephone Number	:	971-202-2442
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/DNP
Name	:	ROSELYNE A OGOLA-MWANGALE
Credential	:	DPN, PMHNP, FNP
Telephone Number	:	971-202-2442

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	02/09/2026

Similar Medicare Providers

1023722774 — TRACY WANG
Practice Location Address:

500 NE MULTNOMAH ST STE 100
PORTLAND, OR
97232-2099

Practice Phone: 503-571-4506
Practice Fax:

1003520750 — MR. DANE JAMES SLAGLE CRNA
Practice Location Address:

500 NE MULTNOMAH ST STE 100
PORTLAND, OR
97232-2099

Practice Phone: 503-571-4506
Practice Fax:

1407708738 — HOLLY SCHAAF
Practice Location Address:

1631 NE BROADWAY ST # 741
PORTLAND, OR
97232-1425

Practice Phone: 503-724-0747
Practice Fax:

1134071467 — EMMALEE HINTZ
Practice Location Address:

1805 NE SANDY BLVD
PORTLAND, OR
97232-2884

Practice Phone: 503-647-6132
Practice Fax:

1023960184 — LEONEL JAKOB-HAWK ESTEL CADC-R, CRM II
Practice Location Address:

1805 NE SANDY BLVD
PORTLAND, OR
97232-2884

Practice Phone: 503-647-6132
Practice Fax:

1780568295 — HEATHER ROSE OTTO PMHNP-BC
Practice Location Address:

1500 NE IRVING ST STE 210
PORTLAND, OR
97232-2243

Practice Phone: 425-477-4215
Practice Fax:

Directions to “ELORE HEALTH SYSTEM LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.