St. Jude Operating Company, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

1026862561 Issued in OR

Legal business name

ST. JUDE OPERATING COMPANY, LLC

Doing business as

Healthcare at Foster Creek

Practice address

6003 SE 136TH Ave
Portland, OR 97236-4567

Phone

(503) 761-1155

Fax

(503) 761-1142

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Melchor Balazs

Title

Owner

Phone

(510) 526-2230

Specialties & licenses 1

Addresses

Other names 1

• Healthcare at Foster Creek Doing business as

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1205053600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 SE 136TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972364567",
            "telephone_number": "503-761-1155",
            "fax_number": "503-761-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 SE 136TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972364567",
            "telephone_number": "503-761-1155",
            "fax_number": "503-761-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "BALAZS",
        "authorized_official_first_name": "MELCHOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-526-2230"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OR",
            "license": "1026862561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare at Foster Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda St. Clair
• Valerie Ann St. Clair
• Luke St. John
• Samuel St. John
• St. Johns Physical Therapy
• Shannon Alexis St. Laurent, AUD
• Carissa Marie St. Onge Carneiro, CNM
• Brittany Nicole St. Onge
• St. Vincent's Hospitol
• Paula J. Staab, RD LD

• Nursing Facility/Intermediate Care Facility in Portland, OR
• Providers in Portland, OR by specialty
• Nursing Facility/Intermediate Care Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.