Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Provider: Providence Cully Residential Care

Provider Information

Providence Cully Residential Care

5119 NE 57TH AVE
Portland, OR 97218

Provider ID
50R321
Administrator
TARA WAGNER-YOSHIWARA
Phone
(503) 215-8050
Email
tara.wagner-yoshiwara@providence.org

Additional Provider Details

ID
50R321
Status
Open
Type
Residential Care Facility
Licensed beds
42
Accepts Medicaid
No
Memory Care
No
Owner
Providence Health & Services-Oregon

1801 LIND AVENUE SW
Renton, 98057

(425) 525-3355
Owner since
12/31/2009

If you have questions about this provider or its inspection and compliance history, please contact the provider at the phone number listed above.