Provider Demographics
NPI:1356647168
Name:TUALITY HEALTHCARE
Entity Type:Organization
Organization Name:TUALITY HEALTHCARE
Other - Org Name:ORENCO STATION MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-681-1567
Mailing Address - Street 1:372 SE 6TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4284
Mailing Address - Country:US
Mailing Address - Phone:503-681-5680
Mailing Address - Fax:503-681-5688
Practice Address - Street 1:6355 NE CORNELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5434
Practice Address - Country:US
Practice Address - Phone:503-597-3130
Practice Address - Fax:503-597-3140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUALITY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-27
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287400Medicaid
380021Medicare PIN