Organization Active NPI

Crestview Operations, LLC

  • Skilled Nursing Facility
  • Portland, OR
National Provider Identifier
1922046606
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CRESTVIEW OPERATIONS, LLC
Practice address
6530 SW 30TH Ave
Portland, OR 97239-1007
Phone
(503) 244-7533
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
K. Rickard Miller Jr.
Title
Manager
Phone
(503) 570-3405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6530 SW 30TH Ave
Portland, OR 97239-1007

Mailing address

25117 SW Parkway Ave
Suite F
Wilsonville, OR 97070-9600

Other names 1

  • Avamere Crestview of Portland Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060720000335 OR Part A Provider - Skilled Nursing Facility 1951314723 Practice locations: Portland, OR

Skilled nursing facility certification: CCN 385031

Legal name
CRESTVIEW OPERATIONS LLC
Doing business as
AVAMERE CRESTVIEW OF PORTLAND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Sep 13, 2024
Beds
127
Ownership / control type
Corporation
Multi-facility organization
Avamere Health Services
Organization structure
LLCProprietary
Enrollment address
6530 SW 30TH Avenue
Portland, OR 97239-1007
Nursing home name
AVAMERE CRESTVIEW OF PORTLAND
Affiliated entity
AVAMERE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avamere Crestview of PortlandCCN 385031
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12765.3 residents per day on average
Chain
Avamere27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 52

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Avamere Skilled Advisors LLC Organization, Wilsonville, OR LLC, For-profit Operational/Managerial Control Oct 1, 2006
Adp of the SNF Jul 3, 2025
Nancy Adams Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Dec 31, 2024
Nursa Inc Organization, Murray, UT Corporation, Medical staffing company, For-profit Adp of the SNF Sep 1, 2023
Sabra Health Care Reit Inc Organization, Tustin, CA Corporation, Holding company, For-profit, Real estate investment trust (REIT) Adp of the SNF Aug 17, 2017
Lori Harrison Individual Adp of the SNF Feb 22, 2021
Heatherann Giles Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Michelle Funderberg Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Dec 31, 2024
Organization, Tustin, CA LLC, For-profit Adp of the SNF Aug 7, 2015
Karl Rickard Miller Individual 5% Or Greater Indirect Ownership Interest May 1, 1997
Ari Operations, LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 1, 2006 100%
Jennifer Dana Individual Operational/Managerial Control May 1, 2022
Adp of the SNF May 1, 2022
Andrew Simpson Individual Operational/Managerial Control Jun 1, 2024
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jun 1, 2024
Midcap Finco LLC Organization, Bethesda, MD LLC, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Jan 22, 2010 100%
Operational/Managerial Control Jan 22, 2010
Glen Robert Cavallo Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Ariso LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2006 100%
Carolyn Staples Individual Adp of the SNF Oct 5, 2023
Karl Rickard Miller Jr Revocable Trust Organization, Ketchum, ID For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 1997 100%
Fusion Medical Staffing LLC Organization, Elkhorn, NE LLC, Medical staffing company, For-profit Adp of the SNF Apr 12, 2024
Avamere Health Services LLC Organization, Wilsonville, OR LLC, For-profit, Chain home office Operational/Managerial Control Oct 1, 2006
Adp of the SNF Jul 13, 2025
David P Larson Individual Operational/Managerial Control Apr 1, 2020
Adp of the SNF Apr 1, 2020
Ike Okoli Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Todd Inskeep Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Jan 21, 2022
Consolidated Billing Services Inc Organization, Spokane Valley, WA Corporation, For-profit Adp of the SNF Apr 24, 1998
CMG Cit Acquisition, LLC Organization, Manchester, NH LLC, Medical staffing company, For-profit Adp of the SNF Dec 18, 2023
Ventura Medstaff, LLC Organization, Omaha, NE LLC, Medical staffing company, For-profit Adp of the SNF Apr 1, 2024
Colby Strunk Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Sep 6, 2022
Justin Polson Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Feb 10, 2025
Kevala Technologies, Inc Organization, Seattle, WA Corporation, Medical staffing company, For-profit Adp of the SNF Oct 31, 2023
Kim Games Individual Adp of the SNF Aug 15, 2024
Rande Holdings, LLC Organization, Wilsonville, OR LLC, For-profit Adp of the SNF Jun 1, 2024
Michele Powelson Individual Operational/Managerial Control Mar 25, 2015
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Mar 25, 2015
Avamere Group LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 1, 2006 100%
Tonia Hoskins Individual Operational/Managerial Control Jul 19, 2024
Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Julie Davis Individual Operational/Managerial Control Aug 1, 2024
Adp of the SNF Aug 1, 2024
Mary Kofstad Individual Operational/Managerial Control Feb 13, 2024
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Feb 13, 2024
Sabra Health Care Limited Partnership Organization, Tustin, CA Holding company, For-profit Adp of the SNF Aug 17, 2017
Yolanda Presley Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Sarah Tijerina Individual Operational/Managerial Control Oct 13, 2023
Adp of the SNF Jul 13, 2025
National Staffing Solutions, Inc Organization, Winter Park, FL Corporation, Medical staffing company, For-profit Adp of the SNF Nov 22, 2023
Jolynn Munro Individual Operational/Managerial Control Sep 1, 2023
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Sep 1, 2023
Aequor Healthcare Services, LLC Organization, Piscataway, NJ LLC, Medical staffing company, For-profit Adp of the SNF Sep 20, 2023
Incovate Solutions, LLC Organization, Charlotte, NC LLC, For-profit Adp of the SNF Jan 21, 2022
Cody Feakin Individual Operational/Managerial Control Jul 15, 2025
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 1, 2025
Misty Dawn Reid Individual Operational/Managerial Control Jan 2, 2025
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 2, 2025
Amanda Sanders Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Kevin Hill Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Mar 12, 2022
Andrea Doepker Individual Operational/Managerial Control Sep 28, 2023
Adp of the SNF Sep 28, 2023
Converdia Health Staffing - Therapies Organization, West Fargo, ND LLC, Medical staffing company, For-profit Adp of the SNF Jul 9, 2024
Sabra Health Care, LLC Organization, Tustin, CA LLC, Holding company, For-profit Adp of the SNF Aug 17, 2017
Moss Adams LLP Organization, Seattle, WA For-profit Adp of the SNF Jan 1, 2009
Phoi Lao Individual Operational/Managerial Control Nov 12, 2024
Adp of the SNF Nov 12, 2024
Carrie Vanderzanden Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 1, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 26

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 26

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1922046606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 SW 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391007",
            "telephone_number": "503-244-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "K. RICKARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-570-3405",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Avamere Crestview of Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.