NPI 1275746414

Park Vista Retirement & Assisted Living Community LLC

Organisation Point of Service Salem, OR

Practice location

Address: 3220 State St Suite 200, Salem, OR 97301-6872
Phone: (506) 566-5715
Fax: (503) 588-3531
Mailing address: 2944 SE Lund Ave, Port Orchard, WA 98366-5547

Authorised official

Name: Kelley D Hamilton
Title: Ceo-Pres of Manager
Phone: (506) 566-5715

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 1810 (WA)

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Registry record

NPI: 1275746414
Entity type: Organization
NPI issued: 7 May 2007
Record last updated: 4 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.