Navajo Lake, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

NAVAJO LAKE, LLC

Practice address

175 NE 16TH St
Madras, OR 97741-2219

Phone

(541) 475-2273

NPI assigned

Dec 16, 2025

Organization subpart

No

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

Authorized official

Name

Ryan Williams

Title

Managing Member

Phone

(916) 299-7030

Specialties & licenses 1

Addresses

Other names 1

• Willow Creek Assisted Living Doing business as

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1083579791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 MENLO DR STE 200",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 NE 16TH ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977412219",
            "telephone_number": "541-475-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAJO LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "916-299-7030"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Creek Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aubrey Mullins
• Mark M Mullins, DC
• Eileen Myers, CADC
• Nancy M Burgess RN MSN Anp-C PC
• Stefanie Amie Naranjo
• Sabrina Navarro
• Holly Neff, QMHA
• Aimee Marie Neill, M.D.
• Robert O Nelson, PT
• Sarah Catherine O'Brien, FNP-C

• Assisted Living Facility in Madras, OR
• Providers in Madras, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.