Mary's Woods at Marylhurst, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MARY'S WOODS AT MARYLHURST, INC

Doing business as

Marie Rose Center

Practice address

17360 Holy Names Dr
Lake Oswego, OR 97034-5137

Phone

(503) 675-2475

Fax

(503) 675-3937

NPI assigned

Nov 1, 2005

Last updated

Jul 24, 2014By 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

Ms. Diane Elizabeth Hood, CPA

Title

Cfo

Phone

(503) 675-2448

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Marie Rose Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1205827037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 HOLY NAMES DR",
            "address_2": "SUITE 70",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345187",
            "telephone_number": "503-675-2447",
            "fax_number": "503-675-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 HOLY NAMES DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345137",
            "telephone_number": "503-675-2475",
            "fax_number": "503-675-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S WOODS AT MARYLHURST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-675-2448",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508756",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800046",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marie Rose Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lake Oswego, OR
• Providers in Lake Oswego, 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 Jul 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.