Pacifica Sylvan Park LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA SYLVAN PARK LLC

Doing business as

Pacifica Senior Living Vancouver

Practice address

2400 NE 112TH Avenue
Vancouver, WA 98684

Phone

(360) 619-5245

Fax

(360) 326-1851

NPI assigned

May 20, 2019

Last updated

May 20, 2019By 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

Deepak Israni

Title

General Manager

Phone

(619) 296-9000

Specialties & licenses 2

Addresses

Other names 1

• Pacifica Senior Living Vancouver Doing business as

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1285291849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK STREET",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE 112TH AVENUE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "360-619-5245",
            "fax_number": "360-326-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SYLVAN PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Vancouver",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pacific Pediatric Feeding Team
• Pacific Phoenix Group PLLC (Pacific Phoenix Psychiatry)
• Pacific Surgical Specialists LLC
• Pacific Surgical Specialists, PLLC
• Pacific Trillium Counseling LLC
• Margaret Pack, FNP-BC
• Jimmy Padar
• Jessica L. Padget, ATC
• Alfred Padilla, MA, DCR, AAC
• Carol Padilla, LMP

• Assisted Living Facility in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.