PROVIDENCE ELDERPLACE (NPI# 1750837597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750837597 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE ELDERPLACE |
| Practice Address |
16430 Ne Hoyt St Portland OR 97230 |
| Mailing Address |
16430 Ne Hoyt St Portland OR 97230-5846 |
| Practice Telephone | 5038755172 |
| Mailing Telephone | 5038755172 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |
| Authorized Official Name | LOMINGO M ANDREWS (LPN) |
| Authorized Official Telephone | 5035469292 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 201130602LPN | OR | Nursing & Custodial Care Facilities |
| Street Address |
16430 NE HOYT ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| 1386026011 | Melissa Sy | Nursing Care | 15915 Ne Glisan St, Portland, OR 97230 | 2015-06-18 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384576 | Pacifica Calaroga Terrace LLC | Assisted Living Facility | 1400 Ne 2nd Ave, Portland, OR 97232-1148 | 2020-10-22 |
| 1366068959 | Harvest Homes Inc | Assisted Living Facility | 6921 N Roberts Ave, Portland, OR 97203-6385 | 2020-06-19 |
| 1700408010 | Senior Haven LLC | Assisted Living Facility | 12140 Se Foster Rd, Portland, OR 97266-4043 | 2020-05-08 |
| 1508407016 | Blandina Chitalah | Assisted Living Facility | 342 Woodford St Unit 1, Portland, ME 04103-5608 | 2019-10-05 |
| 1962058024 | Bright Lantern Home Care | Assisted Living Facility | 14 Powsland St Apt 2, Portland, ME 04102-2622 | 2019-08-14 |
| 1164845921 | Russellville IIi LLC | Assisted Living Facility | 23 Se 103rd Ave, Portland, OR 97216 | 2014-01-30 |
| 1215368840 | The Meadows At Halltown, Inc. | Assisted Living Facility | 711 Halltown Rd, Portland, TN 37148-9071 | 2013-12-08 |
| 1811219397 | Richland Place Senior Living | Assisted Living Facility | 201 Richland Lake Dr, Portland, TN 37148-1775 | 2010-02-24 |
| 1477881951 | Fallbrook Residential Care Facility, Inc. | Assisted Living Facility | 418 Ray St, Portland, ME 04103-3934 | 2009-11-23 |
| 1538387147 | Carriage Inn Limited Partnership | Assisted Living Facility | 401 Northshore Blvd, Portland, TX 78374-3800 | 2007-04-22 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.