MEDICARE: SERENITY HILLS SENIOR LIVING

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

General Provider Information

NPI Number	:	1962355750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY HILLS SENIOR LIVING

Provider Business Mailing Address
First Line	:	16200 SW DIVISION ST
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-2535
Country	:	US
Telephone Number	:	971-441-6626
Fax Number	:	971-708-6976

Provider Business Practice Location Address
First Line	:	16200 SW DIVISION ST
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-2535
Country	:	US
Telephone Number	:	971-441-6626
Fax Number	:	971-708-6976

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	AMANDA MARIE FABIANO
Credential	:
Telephone Number	:	971-441-6622

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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