Provider Demographics
NPI:1639227036
Name:MARQUIS COMPANIES
Entity Type:Organization
Organization Name:MARQUIS COMPANIES
Other - Org Name:MARQUIS CARE AT AUTUMN HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGG
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:971-206-5200
Mailing Address - Street 1:6630 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1404
Mailing Address - Country:US
Mailing Address - Phone:503-292-7874
Mailing Address - Fax:
Practice Address - Street 1:6630 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1404
Practice Address - Country:US
Practice Address - Phone:503-292-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR800800Medicaid