WATERFORD AT FAIRWAY VILLAGE HOME (NPI# 1144267667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144267667 |
| Entity Type | Organization |
| Organization Name | WATERFORD AT FAIRWAY VILLAGE HOME |
| Other Organization Name | TOUCHMARK AT FAIRWAY VILLAGE HOME HEALTH |
| Practice Address |
2909 Se Village Loop Vancouver WA 98683-8108 |
| Mailing Address |
5150 Sw Griffith Dr Beaverton OR 97005-2935 |
| Practice Telephone | 3602542866 |
| Practice Fax Number | 3608833103 |
| Mailing Telephone | 5036465186 |
| Mailing Fax Number | 5036443568 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | MR. BRIAN E PRYOR (EVP OPERATIONS) |
| Authorized Official Telephone | 5036465186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 011429 | WA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CLIA LICENSE | 50D1049339 | 01 |
| Other Name | Type Code |
|---|---|
| Touchmark at Fairway Village Home Health | Doing Business As Name - Organization |
| Street Address |
2909 SE VILLAGE LOOP |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98683-8108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487060901 | Mobilehealthcareprovidersnorthwest | Voluntary or Charitable | 2909 Se Village Loop, Vancouver, WA 98683-8108 | 2014-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761222 | Nathaniel James Eugene Powell | Behavior Technician | 4101se 192nd Ave, Ste 101, Vancouver, WA 98683 | 2020-02-07 |
| 1295294973 | Ubmhc1, LLC | Clinical Medical Laboratory | 18110 Southeast 34th St, Building 2, Suite 240, Vancouver, WA 98683 | 2019-03-13 |
| 1982116695 | Amy K Adams | Massage Therapist | 2716 Se 169th Ave, X-232, Vancouver, WA 98683 | 2017-11-03 |
| 1477088920 | Alexandra Ransonet | Dental Hygienist | 19111 Se 34th. St., Vancouver, WA 98683 | 2017-04-21 |
| 1639618630 | Digestive Gi Care | Internal Medicine | 305 Sw Chkalov Dr, 111-140, Vancouver, WA 98683 | 2017-02-23 |
| 1447706742 | Jennifer Horst | Massage Therapist | 3401 Se 192nd. Ave. Suite 107, Vancouver, WA 98683 | 2016-08-28 |
| 1154702728 | Kacie Marie Hamreus | Physician Assistant | 3101 Se 192nd Avenue, Vancouver, WA 98683 | 2015-06-09 |
| 1851782338 | Kathryn Wiedeman | Physical Therapy Assistant | 801 Se Park Crestt Ave, Vancouver, WA 98683 | 2015-02-05 |
| 1407255326 | Jesse Ryan Moses | Dentist | 16600 Se 15th Street, Suite A, Vancouver, WA 98683 | 2014-08-15 |
| 1366869893 | Stephen J Wold II | Podiatrist | 16701 Ne Mcgillivray Blvd, Ste 220, Vancouver, WA 98683 | 2014-03-21 |
| Find all providers in zip 98683 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538778295 | Eden Home Health of Clark County, LLC | Home Health | 4601 Ne 77th Ave Ste 300, Vancouver, WA 98662-6736 | 2020-07-29 |
| 1255812020 | Healthy Living At Home - Vancouver, LLC | Home Health | 1220 Main St Ste 400, Vancouver, WA 98660-2963 | 2018-08-28 |
| 1871046623 | Rc Home Care Services, Inc. | Home Health | 4555 Ne 66th Ave, Vancouver, WA 98661-3181 | 2016-07-28 |
| 1629436027 | Fortis Healthcare, Inc. | Home Health | 8002 Ne Highway 99, #114, Vancouver, WA 98665-8876 | 2016-02-01 |
| 1356708895 | Vancouver Home Health Care Agency LLC | Home Health | 201 Ne Park Plaza Dr Ste 200, Vancouver, WA 98684-5871 | 2016-01-27 |
| 1952422735 | Elfin Services, Inc. | Home Health | 8509 Ne 69th St, Vancouver, WA 98662-4370 | 2007-04-02 |
| 1184771941 | Family Care Services, Inc | Home Health | 10000 Ne 7th Ave, Suite 210, Vancouver, WA 98685-4599 | 2007-01-04 |
| 1770644668 | Paradox Northwest Associates, Inc | Home Health | 205 E 11th St, Suite Ll1, Vancouver, WA 98660-3200 | 2006-12-13 |
| 1205867819 | Gentiva Certified Healthcare Corp. | Home Health | 204 Se Stone Mill Dr Ste 260, Vancouver, WA 98684-3507 | 2006-07-05 |
| 1407366685 | Divine Home Health Care Inc | Home Health | 4555 Ne 66th Ave, Vancouver, WA 98661-3181 | 2017-10-02 |
| Find all providers in VANCOUVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.