- Enrollment id
- O20111111000680
- Enrollment state
- OR
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1003190547
- Multiple npi flag
- N
- Ccn
- 381566
- Associate id
- 0840464632
- Organization name
- PINNACLE HOSPICE CARE INC
- Doing business as name
- PINNACLE HOSPICE CARE OF PORTLAND
- Incorporation date
- 2011-10-03
- Incorporation state
- OR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10570 SE WASHINGTON ST
- Address line 2
- STE 207
- City
- PORTLAND
- State
- OR
- Zip code
- 972162846