Provider Demographics
NPI:1932323938
Name:TUALITY HEALTHCARE
Entity Type:Organization
Organization Name:TUALITY HEALTHCARE
Other - Org Name:HEART DISEASE PREVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:V
Authorized Official - Last Name:STENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-681-1893
Mailing Address - Street 1:364 SE 8TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4253
Mailing Address - Country:US
Mailing Address - Phone:503-681-4310
Mailing Address - Fax:503-681-1989
Practice Address - Street 1:364 SE 8TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4253
Practice Address - Country:US
Practice Address - Phone:503-681-4310
Practice Address - Fax:503-681-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213077Medicaid
OR213077Medicaid