Organization Active NPI

Moses Lake

  • Assisted Living Facility
  • Moses Lake, WA
National Provider Identifier
1003933896
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MOSES LAKE
Practice address
8425 Aspi Blvd
Moses Lake, WA 98837-3615
Phone
(509) 762-9115
Fax
(503) 485-1279
NPI assigned
Mar 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jon Harder
Title
President
Phone
(503) 485-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

8425 Aspi Blvd
Moses Lake, WA 98837-3615

Mailing address

PO Box 3006
Salem, OR 97302-0006
Phone (503) 485-4600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003933896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020006",
            "telephone_number": "503-485-4600",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 ASPI BLVD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988373615",
            "telephone_number": "509-762-9115",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.