Jennings McCall Center

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

JENNINGS MCCALL CENTER

Practice address

2221 Oak St
Forest Grove, OR 97116-2052

Phone

(503) 359-4465

Fax

(503) 359-8552

NPI assigned

Jun 24, 2020

Organization subpart

Yes

Parent organization

THE MASONIC AND EASTERN STAR HOME OF OREGON, INC.As reported in NPPES

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

Authorized official

Name

Rick Komraus

Title

Grand Secretary

Phone

(503) 357-3158

Specialties & licenses 2

Addresses

Other identifiers 2

Part of

Jennings McCall Center

Locations

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1730705823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 OAK ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162052",
            "telephone_number": "503-359-4465",
            "fax_number": "503-359-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 OAK ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162052",
            "telephone_number": "503-359-4465",
            "fax_number": "503-359-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNINGS MCCALL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MASONIC AND EASTERN STAR HOME OF OREGON, INC.",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "KOMRAUS",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "GRAND SECRETARY",
        "authorized_official_telephone_number": "503-357-3158"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521693",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524956",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Jameson
• Kaitlin Jamieson
• Jared M. Thompson, DMD, LLC
• Andrew J Jaszewski, PA-C
• Daniel Albert Jenisch Sr., O.D
• Grant Johnson, O.D.
• Gregory Melvin Johnson, D.M.D.
• Tiffany Johnson
• Rebekkah Sue Jolliff, PTA
• Jonathan Faris DMD PC

• Assisted Living Facility in Forest Grove, OR
• Providers in Forest Grove, 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 Jun 24, 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.