Provider Demographics
NPI:1023749603
Name:LENSA RESIDENTIAL SERVICE LLC
Entity type:Organization
Organization Name:LENSA RESIDENTIAL SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BERHANU
Authorized Official - Middle Name:K
Authorized Official - Last Name:BEDASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-327-8224
Mailing Address - Street 1:2320 SE 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-3416
Mailing Address - Country:US
Mailing Address - Phone:503-327-8224
Mailing Address - Fax:503-265-8394
Practice Address - Street 1:2320 SE 153RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-3416
Practice Address - Country:US
Practice Address - Phone:503-327-8224
Practice Address - Fax:503-265-8394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty