Russellville III LLC

NPI #1164845921 in Portland, Oregon

Provider Information

NPI Number
1164845921
Entity Type
Organization
Organization Name
Russellville III LLC
Primary Specialty
Assisted Living Facility
Enumeration Date
Jan 30, 2014
Last Updated
Jan 30, 2014

Practice Location

Address
23 SE 103RD AVE
State
Oregon
ZIP Code
97216
Phone
(503) 254-5900

Authorized Official

Name
MR. RAYN RASAR
Title
VP OPERATIONS
Phone
(206) 436-7827

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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