EAGLE HEALTHCARE, INC (NPI# 1659470193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659470193 |
| Entity Type | Organization |
| Organization Name | EAGLE HEALTHCARE, INC |
| Other Organization Name | MENLO PARK HEALTHCARE |
| Practice Address |
745 Ne 122nd Ave Portland OR 97230-2001 |
| Mailing Address |
12015 115th Ave Ne # E195 Kirkland WA 98034-6940 |
| Practice Telephone | 5032520241 |
| Practice Fax Number | 5032579091 |
| Mailing Telephone | 4252853891 |
| Mailing Fax Number | 4252853899 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-12-10 |
| Authorized Official Name | MR. GREG SCHMIDT (CONTROLLER) |
| Authorized Official Telephone | 4252853891 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAGLE HEALTHCARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 800033 | 05 |
| Other Name | Type Code |
|---|---|
| Menlo Park Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578616041 | Eagle Healthcare, Inc | Skilled Nursing Facility | 912 Hillcrest Ave, Grandview, WA 98930-1441 | 2007-01-19 |
| 1588751697 | Eagle Healthcare, Inc | Skilled Nursing Facility | 1242 11th St, Clarkston, WA 99403-2815 | 2006-10-09 |
| 1316034473 | Eagle Healthcare, Inc | Skilled Nursing Facility | 308 W Emma St, Union Gap, WA 98903-1940 | 2006-10-09 |
| 1679665269 | Eagle Healthcare, Inc | Skilled Nursing Facility | 1036 E Victoria Ave, Burlington, WA 98233-1623 | 2006-09-29 |
| 1629175963 | Eagle Healthcare, Inc | Skilled Nursing Facility | 155 Alder Street, Cathlamet, WA 98612-0338 | 2006-09-20 |
| 1265534622 | Eagle Healthcare, Inc | Skilled Nursing Facility | 1000 E. Elep Ave., Colville, WA 99114-0559 | 2006-09-05 |
| 1568497196 | Eagle Healthcare, Inc | Skilled Nursing Facility | 10909 Ne 185th St, Bothell, WA 98011-1709 | 2006-07-12 |
| 1649251653 | Eagle Healthcare, Inc | Skilled Nursing Facility | 2818 Ne 145th St, Shoreline, WA 98155-7556 | 2005-11-07 |
| 1962493015 | Eagle Healthcare, Inc | Skilled Nursing Facility | 721 Otis Ave, Sunnyside, WA 98944-2328 | 2005-10-28 |
| 1265421978 | Eagle Healthcare, Inc | Skilled Nursing Facility | 1745 Pike Ave, Richland, WA 99354-2295 | 2005-10-14 |
| Street Address |
745 NE 122ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144726225 | Ignacio Hidalgo | Physical Therapy Assistant | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2018-04-05 |
| 1548634751 | Aaron R. Proctor | Community Health Worker | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2015-11-26 |
| 1295178606 | Huckleberry Tm Koester | Speech-Language Pathologist | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2013-04-16 |
| 1609124551 | Care Center (menlo Park) Inc. | Skilled Nursing Facility | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2012-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861835456 | Marquis Companies II, Inc. | Skilled Nursing Facility | 319 Ne Russet St, Portland, OR 97211-2815 | 2013-04-12 |
| 1942437298 | Anita August | Skilled Nursing Facility | 300 Nw 8th Ave Apt 707, Portland, OR 97209-3560 | 2009-06-14 |
| 1720151988 | Care Center East Health - Portland, LLC | Skilled Nursing Facility | 11325 Ne Weidler St, Portland, OR 97220-1950 | 2006-11-16 |
| 1932211968 | Marquis Companies I, Inc | Skilled Nursing Facility | 725 Se 202nd Ave, Portland, OR 97233-6105 | 2006-08-31 |
| 1508978537 | Marquis Companies I, Inc | Skilled Nursing Facility | 1475 Se 100th Ave, Portland, OR 97216-2537 | 2006-08-31 |
| 1942312905 | Marquis Companies I, Inc | Skilled Nursing Facility | 6010 Sw Shattuck Rd, Portland, OR 97221-1043 | 2006-08-31 |
| 1205841095 | Adventist Health System Texas, Inc. | Skilled Nursing Facility | 215 Highland Circle Dr, Portland, TN 37148-4918 | 2006-07-30 |
| 1629008651 | Harbor Care Corporation | Skilled Nursing Facility | 3540 Se Francis St, Portland, OR 97202-3350 | 2006-07-04 |
| 1114969912 | West Hills Convalescent Center Limited Partnership | Skilled Nursing Facility | 5701 Sw Multnomah Blvd, Portland, OR 97219-3195 | 2006-06-13 |
| 1922046606 | Crestview Operations, LLC | Skilled Nursing Facility | 6530 Sw 30th Ave, Portland, OR 97239-1007 | 2006-06-03 |
| Find all providers in PORTLAND | ||||
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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.