Sapphire at Gracelen LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

SAPPHIRE AT GRACELEN LLC

Doing business as

Gracelen Care Center

Practice address

10948 SE Boise St
Portland, OR 97266-2202

Phone

(503) 760-1727

NPI assigned

Nov 20, 2023

Last updated

Nov 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Michael Ricker

Title

Managing Member

Phone

(503) 887-7395

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gracelen Care Center Doing business as

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764288000000",
    "number": "1871368753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE 102ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204170",
            "telephone_number": "503-887-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10948 SE BOISE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662202",
            "telephone_number": "503-760-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAPPHIRE AT GRACELEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-887-7395",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500829852",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gracelen Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Portland, OR
• Providers in Portland, OR by specialty
• Nursing Facility/Intermediate Care Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.