PREMIER LIVING CENTER INC. (NPI# 1669099768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669099768 |
| Entity Type | Organization |
| Organization Name | PREMIER LIVING CENTER INC. |
| Other Organization Name | PREMIER LIVING CENTER |
| Practice Address |
5120 Se 118th Ave Portland OR 97266-3250 |
| Mailing Address |
3902 Se 154th Ct Vancouver WA 98683-5355 |
| Practice Telephone | 5037623413 |
| Practice Fax Number | 5037623428 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | JEN SCHNITZER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 5416017228 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 503908 | 05 |
| Other Name | Type Code |
|---|---|
| Premier Living Center | Doing Business As Name - Organization |
| Street Address |
5120 SE 118TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-3250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386798833 | Donald Joseph Hice | Counselor | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2007-01-22 |
| 1063050763 | Jeffrey T Holm | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2019-12-13 |
| 1609111590 | Katrina Eerkes | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2012-12-03 |
| 1780959593 | Jacqueline V Swofford | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2012-03-12 |
| 1144598822 | Corey Dean Anderson | Counselor | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2011-12-08 |
| 1902051139 | Michelle Martin | Adult Companion | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2008-12-02 |
| 1447415336 | Lawrence Lindstrom Ruhf | Counselor | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2008-07-21 |
| 1124298724 | Teresa Barker | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2008-03-10 |
| 1043493737 | Jacob White | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2007-12-17 |
| 1598895708 | Jennifer Ashley Phillips IIi | Case Manager/Care Coordinator | 5120 Se 118th Ave, Portland, OR 97266-3250 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
| Find all providers in zip 97266 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384576 | Pacifica Calaroga Terrace LLC | Assisted Living Facility | 1400 Ne 2nd Ave, Portland, OR 97232-1148 | 2020-10-22 |
| 1366068959 | Harvest Homes Inc | Assisted Living Facility | 6921 N Roberts Ave, Portland, OR 97203-6385 | 2020-06-19 |
| 1700408010 | Senior Haven LLC | Assisted Living Facility | 12140 Se Foster Rd, Portland, OR 97266-4043 | 2020-05-08 |
| 1508407016 | Blandina Chitalah | Assisted Living Facility | 342 Woodford St Unit 1, Portland, ME 04103-5608 | 2019-10-05 |
| 1962058024 | Bright Lantern Home Care | Assisted Living Facility | 14 Powsland St Apt 2, Portland, ME 04102-2622 | 2019-08-14 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1164845921 | Russellville IIi LLC | Assisted Living Facility | 23 Se 103rd Ave, Portland, OR 97216 | 2014-01-30 |
| 1215368840 | The Meadows At Halltown, Inc. | Assisted Living Facility | 711 Halltown Rd, Portland, TN 37148-9071 | 2013-12-08 |
| 1811219397 | Richland Place Senior Living | Assisted Living Facility | 201 Richland Lake Dr, Portland, TN 37148-1775 | 2010-02-24 |
| 1477881951 | Fallbrook Residential Care Facility, Inc. | Assisted Living Facility | 418 Ray St, Portland, ME 04103-3934 | 2009-11-23 |
| Find all providers in PORTLAND | ||||
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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.