Organization Active NPI

Pendleton Ventures LLC

  • Assisted Living Facility
  • Pendleton, OR
National Provider Identifier
1982731089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PENDLETON VENTURES LLC
Doing business as
McKay Creek Estates
Practice address
1601 Southgate PL
Pendleton, OR 97801-9432
Phone
(541) 276-1987
Fax
(541) 278-4788
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory J Vislocky
Title
Managing Member
Phone
(360) 735-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X OR Primary

Addresses

Primary practice location

1601 Southgate PL
Pendleton, OR 97801-9432

Mailing address

7700 NE Parkway Dr
Suite 300
Vancouver, WA 98662-6648
Phone (360) 735-7155

Other identifiers 1

IdentifierTypeStateIssuer
510401MedicaidOR

Other names 1

  • McKay Creek Estates Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982731089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626648",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SOUTHGATE PL",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019432",
            "telephone_number": "541-276-1987",
            "fax_number": "541-278-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLETON VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510401",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McKay Creek Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.