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NPI Code Detail

MEDICARE: HCP ESL PORTLAND OR OPCO LLC

MEDICARE: HCP ESL PORTLAND OR OPCO 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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1942850789
Entity Type Code : Organization
Provider Name (Legal Business Name) : HCP ESL PORTLAND OR OPCO LLC
Provider Business Mailing Address
First Line : SELLWOOD, C/O ECLIPSE SENIOR LIVING, ATTN: LICENSING
Second Line : 5885 MEADOWS RD., #500
City : LAKE OSWEGO
State : OR
Zip : 97035-8646
Country : US
Telephone Number : 971-213-4234
Fax Number : 866-246-9514
Provider Business Practice Location Address
First Line : 8517 SE 17TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97202-7347
Country : US
Telephone Number : 503-542-4800
Fax Number : 503-542-4801
Authorized Official
Title or Position : CONROLLER
Name : AMY W FLEMING
Credential :
Telephone Number : 971-337-3922
Provider Enumeration Date : 09/13/2019
Last Update Date : 09/13/2019

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Directions to “HCP ESL PORTLAND OR OPCO LLC ” Practice Location

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