NPI 1265644736

Bridgewood at Four Seasons LLC

Organisation Point of Service Salem, OR

Practice location

Address: 3220 State St Suite 200, Salem, OR 97301-6872
Phone: (503) 566-5715
Fax: (503) 588-3531
Mailing address: 11700 NE Angelo Dr, Vancouver, WA 98684-4296

Authorised official

Name: Kelley D Hamilton
Title: Ceo-Pres of Manager
Phone: (503) 566-5715

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 1474 (WA)

Other Point of Service providers in Oregon →

Registry record

NPI: 1265644736
Entity type: Organization
NPI issued: 4 May 2007
Record last updated: 4 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.