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NPI Code Detail

MEDICARE: SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION

MEDICARE: SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION
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
1314000000XSkilled Nursing Facility00817OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922095934
Entity Type Code : Organization
Provider Name (Legal Business Name) : SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION
Provider Business Mailing Address
First Line : 14645 SW FARMINGTON RD
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-2727
Country : US
Telephone Number : 503-643-8626
Fax Number : 503-520-1435
Provider Business Practice Location Address
First Line : 14645 SW FARMINGTON RD
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-2727
Country : US
Telephone Number : 503-643-8626
Fax Number : 503-520-1435
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. KATHLEEN A. PARRY
Credential :
Telephone Number : 503-643-8626
Provider Enumeration Date : 10/04/2005
Last Update Date : 03/10/2022

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Directions to “SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION ” Practice Location

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