Organization Active NPI

Tigard Memory Partners, LLC

  • Assisted Living Facility
  • Tigard, OR
National Provider Identifier
1649896291
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
TIGARD MEMORY PARTNERS, LLC
Practice address
9000 SW 91St Ave
Tigard, OR 97223-6809
Phone
(503) 445-4363
NPI assigned
Jun 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Gregory Roderick
Title
Member
Phone
(503) 443-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

9000 SW 91St Ave
Tigard, OR 97223-6809

Mailing address

7420 SW Bridgeport Rd Ste 105
Portland, OR 97224-7790
Phone (503) 597-4906

Other identifiers 1

IdentifierTypeStateIssuer
523784MedicaidOR

Other names 1

  • Washington Gardens Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2194118Washington Gardens Memory Care9000 SW 91St Avenue, Tigard, OR 97223Certificate of waiverSep 27, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1649896291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SW 91ST AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236809",
            "telephone_number": "503-445-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIGARD MEMORY PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523784",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.