Provider Demographics
NPI:1902102379
Name:TUALITY HEALTHCARE
Entity type:Organization
Organization Name:TUALITY HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES-NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-681-1177
Mailing Address - Street 1:1400 SW 5TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:364 SE 8TH AVE
Practice Address - Street 2:SUITE 108-A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4253
Practice Address - Country:US
Practice Address - Phone:503-640-3687
Practice Address - Fax:503-640-3688
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUALITY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-02
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
380021Medicare PIN