Ponderosa Retirement Center Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PONDEROSA RETIREMENT CENTER INC.

Practice address

3300 Englewood Ave
Yakima, WA 98902-1517

Phone

(509) 453-1366

Fax

(509) 452-4907

NPI assigned

Nov 20, 2017

Last updated

Nov 20, 2017By 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. Tina Michelle Moss

Title

Administrator

Phone

(509) 453-1366

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1407360936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 ENGLEWOOD AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021517",
            "telephone_number": "509-453-1366",
            "fax_number": "509-452-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 ENGLEWOOD AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021517",
            "telephone_number": "509-453-1366",
            "fax_number": "509-452-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA RETIREMENT CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-453-1366",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aracely Polanco
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• Charlene Polina
• Robert Lee Pollard Jr., RPH. MHA
• Lurdes Ponce, RN
• Jennifer Kohnlein Pontarolo, D.O.
• Andrew M Poplaski, PHARMD
• Ron Poplyk, CRNA
• Brooklyn Jean Porter
• Holly Porter, LMHC

• Assisted Living Facility in Yakima, WA
• Providers in Yakima, 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 Nov 20, 2017; 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.