Fort Vancouver Memory Care, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

FORT VANCOUVER MEMORY CARE, LLC

Doing business as

Fort Vancouver Memory Care

Practice address

8507 NE 8TH Way
Vancouver, WA 98664-1980

Phone

(360) 892-6628

Fax

(360) 882-5793

NPI assigned

Apr 10, 2015

Last updated

Apr 10, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

EMPRES WASHINGTON HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Dale L. Patterson

Title

Ceo and Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other names 1

• Fort Vancouver Memory Care Doing business as

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428624000000",
    "number": "1811383342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626729",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 NE 8TH WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641980",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT VANCOUVER MEMORY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES WASHINGTON HEALTHCARE, LLC",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO AND MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Vancouver Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Fort Vancouver Convalescent Center LLC
• Fort Vancouver Dental Centre
• Fort Vancouver of Cascadia, LLC
• Fort Vancouver Post Acute, LLC (Fort Vancouver Post Acute)
• Fortis Healthcare, Inc.
• Mackenzie Fortner, SUDPT
• Taizak Fortner, AAC

• Alzheimer Center (Dementia Center) in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Alzheimer Center (Dementia Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; 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.