Provider Demographics
NPI:1174602494
Name:TUALITY HEALTHCARE
Entity type:Organization
Organization Name:TUALITY HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES-NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-681-1177
Mailing Address - Street 1:1400 SW 5TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7545 SE TUALATIN VALLEY HIGHWAY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123
Practice Address - Country:US
Practice Address - Phone:503-681-4223
Practice Address - Fax:503-591-9411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUALITY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-06
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-0095-4261QU0200X
OR14 0095261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR062997Medicaid
R0000WCGVDMedicare PIN