Provider Demographics
NPI:1811940422
Name:HEALTHCARE RESOURCES NORTHWEST INC
Entity type:Organization
Organization Name:HEALTHCARE RESOURCES NORTHWEST INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-251-6266
Mailing Address - Street 1:305 NE 102ND AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4161
Mailing Address - Country:US
Mailing Address - Phone:503-261-6000
Mailing Address - Fax:503-261-6060
Practice Address - Street 1:305 NE 102ND AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4161
Practice Address - Country:US
Practice Address - Phone:503-261-6000
Practice Address - Fax:503-261-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR433125305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
135177Medicare ID - Type Unspecified