Organization Active NPI

Vancouver Care LLC Stonebridge Speciality Care Community

  • Assisted Living Facility
  • Vancouver, WA
National Provider Identifier
1720122278
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
BH 1458 Issued in WA
Legal business name
VANCOUVER CARE LLC STONEBRIDGE SPECIALITY CARE COMMUNITY
Practice address
7900 NE Vancouver Mall Dr
Vancouver, WA 98662-6795
Phone
(360) 882-8800
Fax
(503) 485-1495
NPI assigned
Feb 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Jon Harder
Title
Ceo President
Phone
(503) 485-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X BH 1458 WA Primary

Addresses

Primary practice location

7900 NE Vancouver Mall Dr
Vancouver, WA 98662-6795

Mailing address

PO Box 3006
Salem, OR 97302-0006
Phone (503) 486-4600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720122278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020006",
            "telephone_number": "503-486-4600",
            "fax_number": "503-485-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 NE VANCOUVER MALL DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626795",
            "telephone_number": "360-882-8800",
            "fax_number": "503-485-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER CARE LLC STONEBRIDGE SPECIALITY CARE COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "503-485-4600",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH 1458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.