Pacifica SL Ellensburg LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA SL ELLENSBURG LLC

Practice address

818 E Mountain View Ave
Ellensburg, WA 98926-3866

Phone

(509) 925-1220

NPI assigned

Aug 25, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deepak Israni

Title

General Manager

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Other names 1

• Pacifica Senior Living Ellensburg Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1003362567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263866",
            "telephone_number": "509-925-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SL ELLENSBURG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Ellensburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott M Oltman, O.D.
• Justin Inocencio Orozco
• Birkin Owart, DDS MDS
• Wendy A Owens, M.D.
• William Roby Pace III, M.D.
• Rebecca Palmer-Overmiller
• Robert Palmer
• Sarah Jean Palmer
• Jack Glen Palo
• Carole T Parga, FNP

• Assisted Living Facility in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.