MILWAUKIE CONVALESCENT HOSPITAL INC (NPI# 1568509966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568509966 |
Entity Type | Organization |
Organization Name | MILWAUKIE CONVALESCENT HOSPITAL INC |
Other Organization Name | MILWAUKIE CONVALESCENT CENTER |
Practice Address |
12045 Se Stanley Ave Milwaukie OR 97222 |
Practice Telephone | 5036592323 |
Practice Fax Number | 5033538533 |
Mailing Telephone | 5036592323 |
Mailing Fax Number | 5033538533 |
Enumeration Date | 2007-02-01 |
Last Update Date | 2015-01-21 |
Authorized Official Name | DAVID EIVERS (GM) |
Authorized Official Telephone | 5036592323 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | OR | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 802645 | 05 |
Other Name | Type Code |
---|---|
Milwaukie Convalescent Center | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | MILWAUKIE CONVALESCENT HOSPITAL INC. | 1204 Se Clatsop, Portland, OR 97202 |
Street Address |
12045 SE STANLEY AVE |
City | MILWAUKIE |
State | OR |
Zip Code | 97222 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639693021 | Anna Stabio | Occupational Therapist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2017-07-27 |
1629529532 | Elizabeth Martino | Physical Therapist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2016-10-17 |
1659724979 | Kelsey Jeter | Occupational Therapy Assistant | 12045 Se Stanley Ave, Milwaukie, OR 97222 | 2016-07-21 |
1225499973 | Jens Frojen | Speech-Language Pathologist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2016-03-09 |
1417322017 | Mary Aguilar | Community Health Worker | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2015-12-08 |
1205204609 | Care Center (milwaukie) Inc. | Skilled Nursing Facility | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2015-09-02 |
1588063366 | Brenda Jacob | Physical Therapy Assistant | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2014-08-18 |
1861815789 | April Yahna | Occupational Therapist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2014-01-28 |
1770742868 | Kathleen Sue Ugelstad | Occupational Therapist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2008-06-04 |
1881893014 | Cora Sue Nickel | Day Training/Habilitation Specialist | 12045 Se Stanley Ave, Milwaukie, OR 97222-2938 | 2007-07-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
Find all providers in zip 97222 |
Taxonomy Code | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114492519 | Maple Hollow Rehabilitation and Nursing LLC | Nursing Facility/Intermediate Care Facility | 34 Ne 20th Ave, Portland, OR 97232-3019 | 2018-10-11 |
1124550322 | Lisa's Healing and Helping Hands | Nursing Facility/Intermediate Care Facility | 11832 Ne Couch St, Portland, OR 97220-2358 | 2017-03-28 |
1871996710 | Yamhill County Health and Human Services | Nursing Facility/Intermediate Care Facility | 627 Ne Evans St., Mcminnille, OR 97128 | 2014-10-07 |
1245598531 | Lane County Community Health Centers | Nursing Facility/Intermediate Care Facility | 3355 N Delta Hwy Unit 108, Eugene, OR 97408-5913 | 2012-04-25 |
1760717078 | Eea Company | Nursing Facility/Intermediate Care Facility | 33910 E Columbia Ave, Scappoose, OR 97056-3309 | 2009-10-05 |
1194900399 | Arntz Medical | Nursing Facility/Intermediate Care Facility | 229 N Egan, Burns, OR 97720 | 2008-01-07 |
1003020686 | Hillside Senior Living Community, LLC | Nursing Facility/Intermediate Care Facility | 300 Nw Hillside Park Way, Mcminnville, OR 97128 | 2007-05-10 |
1205053600 | St. Jude Operating Company, LLC | Nursing Facility/Intermediate Care Facility | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2007-04-19 |
1427273614 | Rose Linn Care Center | Nursing Facility/Intermediate Care Facility | 2330 Debok Rd, West Linn, OR 97068-3902 | 2007-04-15 |
1861521312 | Blue Mountain Hospital District | Nursing Facility/Intermediate Care Facility | 112 E 5th St, Prairie City, OR 97869 | 2007-03-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.