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Contact Information

ILENE HIBBERT
7668 SW MOHAWK ST
TUALATIN, OR97062-8119
 Phone: 503-885-5110
 Fax: 866-350-1311
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Maintenance Organization

302R00000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1922427657
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/09/2014
Last updated 04/09/2014 - About 12 years ago
Identifiers
OR License # 093003236RN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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