Pinecrest Senior Villa

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

PINECREST SENIOR VILLA

Practice address

1808 SE 182ND Ave
Portland, OR 97233-5120

Phone

(503) 465-4425

NPI assigned

Mar 3, 2014

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

General Manager

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Tax ID family

Pinecrest Senior Villa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St. Andrews Memory Care

  • Alzheimer Center (Dementia Center)
  • Portland, OR
  • NPI 1316362189
  NPD tax ID

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1679998447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 SE 182ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335120",
            "telephone_number": "503-465-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST SENIOR VILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Kay Pinches, PH.D.
• Alexander James Pinck, COTA/L
• Montana Pindell, CSWA
• Pine Mountain Counseling
• Diedra M Pine, MOT
• Amy Pineda, PT
• Jorge Alberto Pineda Jr., M.D.
• Fatima Pinedo Botello
• Andrea Sue Pinedo
• Andrea I Pinger

• Alzheimer Center (Dementia Center) in Portland, OR
• Providers in Portland, OR by specialty
• Alzheimer Center (Dementia Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.