Evergreen Oregon Healthcare Corvallis, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1912975489 Issued in OR

Legal business name

EVERGREEN OREGON HEALTHCARE CORVALLIS, L.L.C.

Doing business as

Conifer House

Practice address

145 NE Conifer Blvd
Corvallis, OR 97330-4105

Phone

(541) 757-2444

Fax

(541) 757-8621

NPI assigned

Sep 24, 2010

Last updated

Jun 2, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

EVERGREEN OREGON HEALTHCARE, L.L.C.As reported in NPPES

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

Authorized official

Name

Dale L Patterson

Title

Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other names 1

• Conifer House Doing business as

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1538478516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626729",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 NE CONIFER BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304105",
            "telephone_number": "541-757-2444",
            "fax_number": "541-757-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN OREGON HEALTHCARE CORVALLIS, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN OREGON HEALTHCARE, L.L.C.",
        "enumeration_date": "2010-09-24",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1912975489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conifer House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Joseph Evans
• Jonathan Wallace Evans, D.O.
• Julie B Evans, MS
• Paul Michael Evans, MD, PHD
• Steven Mark Evans, PHARMD
• Evergreen Wellness Counseling LLC
• Amy Evilsizer, ATC
• Matthew P Evitts, DO
• Kevin DJ Ewanchyna, M.D.
• Mary Kay Ewing, OT

• Assisted Living Facility in Corvallis, OR
• Providers in Corvallis, 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 2, 2011; 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.