Provider Demographics
NPI:1013733211
Name:WILLAMETTE HEALTHCARE LLC
Entity type:Organization
Organization Name:WILLAMETTE HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:TUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-207-2726
Mailing Address - Street 1:1200 EXECUTIVE PKWY STE 410
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2169
Mailing Address - Country:US
Mailing Address - Phone:541-461-0325
Mailing Address - Fax:
Practice Address - Street 1:1200 EXECUTIVE PKWY STE 410
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2169
Practice Address - Country:US
Practice Address - Phone:541-461-0325
Practice Address - Fax:541-461-0571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health