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Contact Information

MIRABELLA AT SOUTH WATERFRONT
3550 S BOND AVE
PORTLAND, OR97239-4507
 Phone: 503-688-6400
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for MIRABELLA AT SOUTH WATERFRONT

NPI Number 1487975959
LBN Legal business name MIRABELLA AT SOUTH WATERFRONT
Authorized official SHARON VAN EATON - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/18/2010
Last updated 12/02/2025 - About 6 months ago
Identifiers
OR License # 1233196437
OR License # 1291022896
OR License # 1753514587
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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