MEDICARE: CAMAS AL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2733	OTHER	WA	ASSISTED LIVING LICENSE

General Provider Information

NPI Number	:	1205762101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMAS AL, LLC

Provider Business Mailing Address
First Line	:	2647 NW KENT ST
Second Line	:
City	:	CAMAS
State	:	WA
Zip	:	98607-9026
Country	:	US
Telephone Number	:	360-967-0940
Fax Number	:

Provider Business Practice Location Address
First Line	:	2647 NW KENT ST
Second Line	:
City	:	CAMAS
State	:	WA
Zip	:	98607-9026
Country	:	US
Telephone Number	:	360-967-0940
Fax Number	:

Authorized Official
Title or Position	:	SR. VP OF OPERATIONS
Name	:	CHRIS SPENCER
Credential	:
Telephone Number	:	332-322-1990

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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