EVERGREEN OREGON HEALTHCARE PORTLAND, L.L.C.
Nursing at Stark St, Portland, OR

License number
Oregon 1676
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: BRENT WEIL
Title: CEO AND MANAGER
Phone: (360) 892-6628
Address
Address 2
12441 SE Stark St, Portland, OR 97233
4601 NE 77Th Ave SUITE 300, Vancouver, WA 98662
National Provider ID: 1497703110
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about EVERGREEN OREGON HEALTHCARE PORTLAND, L.L.C. at bizstanding.com

EVERGREEN OREGON HEALTHCARE PORTLAND, LLC

Portland, OR  -  Vancouver, WA

Registration:
Feb 12, 1997
Addresses:
12441 SE Stark St, Portland, OR 97233 (Physical)
Attn Patti Groth 4601 Ne 77 Ave STE 300, Vancouver, WA 98662 (Mailing)
State ID:
55857388
Business type:
Domestic Limited Liability Company
Agent:
Roland Johnson,200 W Main St, Enterprise, OR 97828 (Physical)

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