Hde Home Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

15-2229 Issued in OR

Legal business name

HDE HOME CARE

Practice address

12655 SW Center St Ste 450
Beaverton, OR 97005-4726

Phone

(503) 686-9079

NPI assigned

Aug 22, 2018

Last updated

Aug 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan Bradetich

Title

Staffing Coordinator

Phone

(503) 686-9079

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1932680584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 450",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 450",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054726",
            "telephone_number": "503-686-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HDE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADETICH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "STAFFING COORDINATOR",
        "authorized_official_telephone_number": "503-686-9079"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Beaverton, OR
• Providers in Beaverton, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.