Summerplace Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUMMERPLACE ASSISTED LIVING LLC

Practice address

15727 NE Russell St
Portland, OR 97230-8222

Phone

(503) 252-9361

Fax

(503) 252-9405

NPI assigned

Feb 27, 2007

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

Managing Member

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Summerplace Assisted Living Community Doing business as

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164559282",
    "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": "15727 NE RUSSELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972308222",
            "telephone_number": "503-252-9361",
            "fax_number": "503-252-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERPLACE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "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": "MANAGING MEMBER",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502073",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerplace Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Summer
• Lily Barbara Summer, PA-C
• Andrew Lee Summerer, PSYD
• Whitney Summerer, LPC ASSOCIATE
• Maxwell Lee Summerlin
• Summerplace Community Healthcare LLC
• Summers Point Therapy LLC
• Caren Elizabeth Summers-Nomura, MS
• Aaron Beaugh Summers, DNP-FNP
• Allison Irene Summers, OD

• Assisted Living Facility in Portland, OR
• Providers in Portland, 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 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.