Provider Demographics
NPI:1366769168
Name:BNS SERVICES LLC
Entity type:Organization
Organization Name:BNS SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-855-4415
Mailing Address - Street 1:19365 SW 65TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9196
Mailing Address - Country:US
Mailing Address - Phone:503-855-4415
Mailing Address - Fax:503-855-4425
Practice Address - Street 1:19365 SW 65TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9196
Practice Address - Country:US
Practice Address - Phone:503-855-4415
Practice Address - Fax:503-855-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2190253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR251E0000XMedicaid