Provider Demographics
NPI:1326039827
Name:TAKE CARE HEALTH SYSTEMS
Entity Type:Organization
Organization Name:TAKE CARE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF NURSE PRACTIONER FOR TCHS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PNP
Authorized Official - Phone:484-832-4468
Mailing Address - Street 1:2185 NW MAST PL
Mailing Address - Street 2:APARTMENT D
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-4001
Mailing Address - Country:US
Mailing Address - Phone:541-994-8569
Mailing Address - Fax:
Practice Address - Street 1:1900 MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1057
Practice Address - Country:US
Practice Address - Phone:503-557-9283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP77388Medicare UPIN