Seaside Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SEASIDE SENIOR LIVING LLC

Doing business as

NECANICUM VILLAGE Assisted Living & Memory Care Community

Practice address

2500 South Roosevelt Dr
Seaside, OR 97138-6366

Phone

(503) 738-0900

NPI assigned

Mar 25, 2007

Last updated

Jul 14, 2008By 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

Jon M Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 3

Addresses

Other names 1

• NECANICUM VILLAGE Assisted Living & Memory Care Community Doing business as

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1285751081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020006",
            "telephone_number": "503-375-9016",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 SOUTH ROOSEVELT DR",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971386366",
            "telephone_number": "503-738-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1401008247",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": "1701870142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NECANICUM VILLAGE Assisted Living & Memory Care Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jada Scott
• Mark Scurrah, MD
• Seaside Chiropractic Clinic P C
• Seaside Dental Clinic
• Seaside Precision Vision
• Seaside Urgent Care
• Seaside Wellness Center LLC
• Lori Sue Shellman, APRN
• Rachel A Shepard, FNP
• Laurie Simpkins

• Assisted Living Facility in Seaside, OR
• Providers in Seaside, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.