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Octavia M Nightingale
Pediatric Skilled Nursing Facility in Lake Oswego, Oregon
NPI 1225639826

Octavia M Nightingale is a Pediatric Skilled Nursing Facility based in Lake Oswego, OR and is specialized in Nursing Care, Pediatric. Octavia M Nightingale practices in Lake Oswego, OR. The NPI Number for Octavia M Nightingale is 1225639826 and holds a License No. 513068 (Oregon).

The current practice location address for Octavia M Nightingale is 4190 Collins Way, Lake Oswego, OR and can be reached out via phone at 503-636-0966 and via fax at 503-675-3552.

Location: 4190 Collins Way, Lake Oswego, OR, 97035-3448
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225639826
Provider Name
Octavia M Nightingale
Credential
Provider Entity Type
Individual
Gender
Female
Address
4190 Collins Way, Lake Oswego, OR, 97035-3448
Phone Number
503-636-0966
Fax Number
503-675-3552
Provider Enumeration Date
11/02/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
513068 05 OR
institution
Provider Business Practice Location Address Details
Address
4190 Collins Way
City
Lake Oswego
State
Oregon
Zip
97035-3448
Phone Number
503-636-0966
Fax Number
503-675-3552
person
Provider Business Mailing Address Details
Address
4190 Collins Way
City
Lake Oswego
State
Oregon
Zip
97035-3448
Phone Number
503-636-0966
Fax Number
503-675-3552
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Skilled Nursing Facility
Speciality
Nursing Care, Pediatric
Taxonomy
3140N1450X
License No.
513068 (Oregon)
Definition
A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
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