Avamere Stafford Operations, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AVAMERE STAFFORD OPERATIONS, LLC

Practice address

1200 Overlook Dr
Lake Oswego, OR 97034-6605

Phone

(503) 636-4589

NPI assigned

Sep 4, 2020

Last updated

Sep 4, 2020By 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

Karl R. Miller Jr.

Title

Ceo

Phone

(503) 570-3405

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1619581865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OVERLOOK DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970346605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OVERLOOK DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970346605",
            "telephone_number": "503-636-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAMERE STAFFORD OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-570-3405",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merriel Monet Ater
• Stephen Spencer Austad, DO
• Barry Michael Austin, M.D.
• Kaila Autrey, LMT
• Avamere Lake Oswego Operations Investors, LLC
• Tristan Avery
• Kathleen Joyce Ayres, LPC, NCC
• Ronda Lynn Babcock, RN
• Francis Bacik
• Adam Richard Bailey, PA-C

• Assisted Living Facility in Lake Oswego, OR
• Providers in Lake Oswego, 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 Sep 4, 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.