Maryville Nursing Home

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

MARYVILLE NURSING HOME

Practice address

14645 SW Farmington Rd
Beaverton, OR 97007-2727

Phone

(503) 643-8626

Fax

(503) 520-1435

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen Parry

Title

Administrator

Phone

(503) 643-8626

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

Maryville Nursing Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sisters of St. Mary of Oregon Maryville Corporation

  dba Maryville Nursing Home

  • Skilled Nursing Facility
  • Beaverton, OR
  • NPI 1922095934
  NPD tax ID

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1285631036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970072727",
            "telephone_number": "503-643-8626",
            "fax_number": "503-520-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970072727",
            "telephone_number": "503-643-8626",
            "fax_number": "503-520-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PARRY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-643-8626",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806745",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Robert Martini, CADC2
• Daniel Martino, PA-C, CAQ-PSYCH
• Megan Martinson
• Michael Martynowicz
• Mary Ann Mendez
• Heidi A Masanga, R.N.
• Eliana Marie Mason, REGISTERED ASSOCIATE
• Nevin Masri, DPT
• Master Eye Associates, P.C.
• Colleen Mathew

• Alzheimer Center (Dementia Center) in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Alzheimer Center (Dementia Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.