Provider Demographics
NPI:1821810714
Name:EASE MY WAY COMMUNITY CARE AGENCY LLC
Entity type:Organization
Organization Name:EASE MY WAY COMMUNITY CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:J HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GBOTOE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD, EDD
Authorized Official - Phone:503-756-6123
Mailing Address - Street 1:1320 NW RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-4844
Mailing Address - Country:US
Mailing Address - Phone:503-756-6123
Mailing Address - Fax:
Practice Address - Street 1:4506 SE BELMONT ST STE 103
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1658
Practice Address - Country:US
Practice Address - Phone:503-756-6123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care