Care Center (Molalla) Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CARE CENTER (MOLALLA) INC.

Doing business as

Molalla Manor Care Center

Practice address

301 Ridings Ave
Molalla, OR 97038-9201

Phone

(503) 829-5591

Fax

(503) 829-9127

NPI assigned

Sep 22, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory J Vislocky

Title

Exec. VP of Finance

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Molalla Manor Care Center Doing business as

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154317402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626648",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIDINGS AVE",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970389201",
            "telephone_number": "503-829-5591",
            "fax_number": "503-829-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER (MOLALLA) INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXEC. VP OF FINANCE",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "809178",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molalla Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michaela Dawn Bowles, FNP-BC
• Katherine Anne Bruneau, R.N.
• John H Brunscheon, R.PH.
• Brian B Buttler, D.C., N.D.
• Maria Caddy
• Lehua Chen
• Dani Clifton
• Laurie Coney, PTA
• Cynthia Cox, M.A., LPC INTERN
• Joshua Joseph Coyle, PHARMD

• Skilled Nursing Facility in Molalla, OR
• Providers in Molalla, OR by specialty
• Skilled Nursing Facility in Oregon

• 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.