Provider Demographics
NPI:1053630491
Name:CAREOREGON COMMUNITY HEALTH, LLC
Entity Type:Organization
Organization Name:CAREOREGON COMMUNITY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:503-416-5764
Mailing Address - Street 1:315 SW 5TH AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1739
Mailing Address - Country:US
Mailing Address - Phone:503-416-4100
Mailing Address - Fax:503-416-1478
Practice Address - Street 1:17175 SW TUALATIN VALLEY HWY
Practice Address - Street 2:SUITE B-2
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4584
Practice Address - Country:US
Practice Address - Phone:503-848-5861
Practice Address - Fax:503-848-5863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREOREGON, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-25
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty