Provider Demographics
NPI:1780556381
Name:TRUE PATH HEALTH SUPPORT LLC
Entity type:Organization
Organization Name:TRUE PATH HEALTH SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-998-0882
Mailing Address - Street 1:17126 SE KELLY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-1249
Mailing Address - Country:US
Mailing Address - Phone:971-998-0882
Mailing Address - Fax:
Practice Address - Street 1:17126 SE KELLY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-1249
Practice Address - Country:US
Practice Address - Phone:971-998-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service