Sisters of St. Mary of Oregon Maryville Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

00817 Issued in OR

Legal business name

SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION

Practice address

14645 SW Farmington Rd
Beaverton, OR 97007-2727

Phone

(503) 643-8626

Fax

(503) 520-1435

NPI assigned

Oct 4, 2005

Organization subpart

Yes

Parent organization

SISTERS OF ST. MARY OF OREGONAs reported in NPPES

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

Authorized official

Name

Mrs. Kathleen A. Parry

Title

Administrator

Phone

(503) 643-8626

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maryville Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Skilled nursing facility certification: CCN 385166

Legal name

SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION

Doing business as

MARYVILLE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 22, 1985

Last certification

Apr 11, 2025

Beds

165

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 26, 1979 in OR

Enrollment address

14645 SW Farmington Rd
Beaverton, OR 97007-2727

Nursing home name

MARYVILLE

Listed as

MaryvilleCCN 385166

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Feb 22, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

165130.1 residents per day on average

Penalties (3 years)

1Fines totaling $107,136

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Maryville Nursing Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Maryville Nursing Home

  • Alzheimer Center (Dementia Center)
  • Beaverton, OR
  • NPI 1285631036
  NPD tax ID

All disclosed owners & managing parties 24

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Christopher Roderick Morris, M.D.

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1699960369

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1922095934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970072727",
            "telephone_number": "503-643-8626",
            "fax_number": "503-520-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970072727",
            "telephone_number": "503-643-8626",
            "fax_number": "503-520-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF ST. MARY OF OREGON MARYVILLE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF ST. MARY OF OREGON",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "PARRY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-643-8626",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": "00817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00817",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryville Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maryville Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harvey Singh, LMT
• Mukhdip Singh, MD
• Amber Singleton
• Forrest Guy Sippey, MSW, CDP, CADCII
• Elijah Siron
• Ashleigh Sizemore
• Delanie Sizemore
• Stefani Skidmore, MA, LPC-INTERN
• Jonathan Sklar, M.S.
• Ruth Ann Skodacek, LCSW,QMHP,CADC

• Skilled Nursing Facility in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.