Park Vista Retirement & Assisted Living Community LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

1810 Issued in WA

Legal business name

PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC

Doing business as

Park Vista Retirement & Assisted Living Community

Practice address

3220 State St
Suite 200
Salem, OR 97301-6872

Phone

(506) 566-5715

Fax

(503) 588-3531

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kelley D Hamilton

Title

Ceo-Pres of Manager

Phone

(506) 566-5715

Specialties & licenses 1

Addresses

Other names 1

• Park Vista Retirement & Assisted Living Community Doing business as

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1275746414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2944 SE LUND AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665547",
            "telephone_number": "360-871-2323",
            "fax_number": "360-871-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 STATE ST",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016872",
            "telephone_number": "506-566-5715",
            "fax_number": "503-588-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO-PRES OF MANAGER",
        "authorized_official_telephone_number": "506-566-5715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "1810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Vista Retirement & Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carla Paradine
• Paradoxos, LLC
• Valarie Marie Pardee, EFDA, EFODA, CDA
• Parenthood Partners
• Halley Paris-Baune
• Danbi Park
• Jin Park
• Ken Jongho Park, M.D.
• Cynthia Anne Parker
• Deborah Ann Parker, CPSS

• Point of Service in Salem, OR
• Providers in Salem, OR by specialty
• Point of Service in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.