Provider Demographics
NPI:1144951716
Name:ZACHARY & ROOBLE LLC
Entity type:Organization
Organization Name:ZACHARY & ROOBLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IFRAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-912-6577
Mailing Address - Street 1:20632 SE MAIN DR
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2250
Mailing Address - Country:US
Mailing Address - Phone:503-912-6577
Mailing Address - Fax:503-328-6055
Practice Address - Street 1:20632 SE MAIN DR
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2250
Practice Address - Country:US
Practice Address - Phone:503-912-6577
Practice Address - Fax:503-328-6055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care