RSL Tualatin, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RSL TUALATIN, LLC

Doing business as

Farmington Square Tualatin

Practice address

17950 SW 115TH Ave
Tualatin, OR 97062-7044

Phone

(503) 692-1748

Fax

(503) 691-2759

NPI assigned

Jun 17, 2020

Last updated

Jun 17, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

RADIANT COMPANIES, INC.As reported in NPPES

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

Authorized official

Name

James Guffee

Title

President of Manager

Phone

(503) 595-2810

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• FARMINGTON SQUARE TUALATIN Doing business as

Locations

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1477179208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235505",
            "telephone_number": "503-595-2810",
            "fax_number": "503-595-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17950 SW 115TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627044",
            "telephone_number": "503-692-1748",
            "fax_number": "503-691-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSL TUALATIN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIANT COMPANIES, INC.",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "GUFFEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT OF MANAGER",
        "authorized_official_telephone_number": "503-595-2810"
    },
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENTIAL CARE FACILITY LICENSE",
            "identifier": "1392751037",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522964",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522965",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMINGTON SQUARE TUALATIN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rose City Dialysis, LLC (Fresenius Kidney Care Tualatin)
• Bobbi Lee Roth, FNP
• Theresa Maher Roth, MA OTR L CHT
• James T Rovang, MD
• David Royster III
• Marilyn L Rudin, M.D.
• Joanne Rudoff, M.D.
• John Rudoff, M.D.
• Karla Rudolph
• Emma Rutherford

• Assisted Living Facility in Tualatin, OR
• Providers in Tualatin, 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 Jun 17, 2020; 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.