Vierck LTD

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

456900 Issued in WA

Legal business name

VIERCK LTD

Doing business as

Canyon Creek Adult Family Home

Practice address

22918 NE 169TH St
Brush Prairie, WA 98606-8716

Phone

(360) 907-3997

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Darren David Vierck, RN

Title

President

Phone

(360) 907-3997

Specialties & licenses 1

Addresses

Other names 1

• Canyon Creek Adult Family Home Doing business as

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1568800035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22918 NE 169TH ST",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986068716",
            "telephone_number": "360-907-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22918 NE 169TH ST",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986068716",
            "telephone_number": "360-907-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIERCK LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "VIERCK",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-907-3997",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "456900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Creek Adult Family Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily P Stewart, LMP
• Esateys Stuchiner
• Lesli G Taylor
• Quan Minh Tran, INTERPRETER
• Kelly Marie Trinklein
• Debra Vogel
• Loretta Walsh, SLP
• Debby Anne Warren-Manning, M.S. CCC-SLP
• Sara Wilhelm
• Jerry B Williams, DDS

• Adult Care Home Facility in Brush Prairie, WA
• Providers in Brush Prairie, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.