Eagle Healthcare, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EAGLE HEALTHCARE, INC

Doing business as

Menlo Park Healthcare

Practice address

745 NE 122ND Ave
Portland, OR 97230-2001

Phone

(503) 252-0241

Fax

(503) 257-9091

NPI assigned

Sep 21, 2006

Organization subpart

Yes

Parent organization

EAGLE HEALTHCARE, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Greg Schmidt

Title

Controller

Phone

(425) 285-3891

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Menlo Park Healthcare Doing business as

Part of

Eagle Healthcare at Camas

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1659470193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12015 115TH AVE NE # E195",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346940",
            "telephone_number": "425-285-3891",
            "fax_number": "425-285-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302001",
            "telephone_number": "503-252-0241",
            "fax_number": "503-257-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTHCARE, INC",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "425-285-3891",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800033",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Menlo Park Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• E3 Physio LLC
• Each Peach Family Wellness
• Brenda Eads
• Michael Andre Eads
• Jessica Dawn Eagan, MSW, MS
• Patrick G Eagle Staff, PWS/QMHP-C
• Rose Eagle, PH.D.
• Tara Lyn Eagle, D.O.
• Geneva Ann Eagon, PA
• Adam Jerome Eakin

• Skilled Nursing Facility in Portland, OR
• Providers in Portland, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.