NPIMap

Organization Active NPI

Willamette Healthcare LLC

  • Community Based Hospice Care Agency
  • Eugene, OR
National Provider Identifier
1750104485
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
WILLAMETTE HEALTHCARE LLC
Practice address
1200 Executive Pkwy Ste 400
Eugene, OR 97401-2168
Phone
(541) 689-3508
Fax
(541) 607-1739
NPI assigned
Nov 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1200 Executive Pkwy Ste 400
Eugene, OR 97401-2168

Mailing address

1200 Executive Pkwy Ste 400
Eugene, OR 97401-2168

Other practice location 1

804 Old Salem Rd NE
Albany, OR 97321-4539
Phone (541) 812-5254

Other names 1

  • Signature Healthcare at Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123002347 OR Part A Provider - Hospice 1254860067 Practice locations: Albany, OR; Eugene, OR

Hospice certification: CCN 381576

Legal name
WILLAMETTE HEALTHCARE LLC
Doing business as
SIGNATURE HEALTHCARE AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 19, 2021
Last certification
Jul 19, 2021
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Enrollment address
1200 Executive Pkwy
Ste 400
Eugene, OR 97401-2168

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Signature Healthcare at HomeCCN 381576
Ownership
For-Profit
Certified
Jul 19, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Signature Healthcare at Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1200 Executive Pkwy
Ste 400
Eugene, OR 97401
Phone (541) 689-3508

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
MHD Tarek Nashawi Individual Contracted Managing EmployeeMD; Jan 1, 2025
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2025 100%
Scott J. Shirts Individual W-2 Managing EmployeeAd; May 1, 2025
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector Jan 1, 2025
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
John J Gochnour Individual Corporate OfficerPresident/LLC Manager Jan 1, 2025
Amber Tueller Individual Corporate OfficerSecretary Jan 1, 2025
Elliot McMillan Individual Corporate OfficerVice President Jan 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2025 Change of OwnershipThis provider was the buyer Signature Healthcare at HomeCCN 381576, OR, NPI 1043817000

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1750104485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EXECUTIVE PKWY STE 400",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EXECUTIVE PKWY STE 400",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012168",
            "telephone_number": "541-689-3508",
            "fax_number": "541-607-1739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Old Salem Rd NE",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973214539",
            "country_code": "US",
            "telephone_number": "541-812-5254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLAMETTE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.