Provider Demographics
NPI:1407984271
Name:INTERIM HEALTHCARE OF OREGON, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF OREGON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-456-5665
Mailing Address - Street 1:3903 SW KELLY AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-7511
Mailing Address - Country:US
Mailing Address - Phone:503-761-6050
Mailing Address - Fax:503-761-5425
Practice Address - Street 1:9498 SW BARBUR BLVD STE 310
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5423
Practice Address - Country:US
Practice Address - Phone:503-761-6050
Practice Address - Fax:503-761-5425
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF SPOKANE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2225253Z00000X
OR15-2016253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care