Provider Demographics
NPI:1376642959
Name:SLEEP HEALTH & WELLNESS NW-ASTORIA
Entity Type:Organization
Organization Name:SLEEP HEALTH & WELLNESS NW-ASTORIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-465-9414
Mailing Address - Street 1:2460 NE GRIFFIN OAKS ST
Mailing Address - Street 2:SUITE D 1000
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-2672
Mailing Address - Country:US
Mailing Address - Phone:503-352-0700
Mailing Address - Fax:503-352-0705
Practice Address - Street 1:1230 MARINE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4059
Practice Address - Country:US
Practice Address - Phone:503-325-8209
Practice Address - Fax:503-325-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic