PRINCETON VILLAGE ASSISTED LIVING RESIDENCE
NPI 1144433384
Point of Service in Salem, OR

Q: What is Princeton Village Assisted Living Residence LLC's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

Active since May 07, 2007CLIA 38D2132188 · Waiver

3220 STATE ST, SUITE 200, SALEM, OR 97301(503) 566-5715(503) 588-3531 Get Directions Write a Review

NPPES record last updated: October 4, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Princeton Village Assisted Living Residence NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRINCETON VILLAGE ASSISTED LIVING RESIDENCE (NPI 1144433384) is a healthcare organization registered as a point of service in Salem, Oregon and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through June 12, 2027 and lists Kelley D Hamilton, Ceo-pres Of Manager, as its authorized official.

NPPES Registry Identity

NPI1144433384

Entity TypeOrganization

Primary Taxonomy305S00000X

Legal Business NamePRINCETON VILLAGE ASSISTED LIVING RESIDENCE LLC

Location Address3220 STATE ST, SUITE 200Salem, OR 97301-6872

Mailing Address14370 Se Oregon Trail DrClackamas, OR 97015-6290 · (503) 558-1215 · Fax (503) 558-8437

Phone(503) 566-5715

Fax(503) 588-3531

Organization SubpartNo

Authorized OfficialKelley D HamiltonCeo-pres Of Manager · (503) 566-5715

Enumeration DateMay 7, 2007

Last NPPES UpdateOctober 4, 2007

✔ NPI 1144433384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations

Taxonomy Code305S00000X

Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

3220 STATE ST, Salem, OR 97301

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Other Names 1

Doing Business AsPrinceton Village Assisted Living Residence

Other Identifiers 1

Other642749-89OR · Registry #

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2132188

Princeton Village Assisted Living Community · Clackamas, OR

Active · expires Jun 12, 2027

CLIA Number38D2132188

Laboratory TypeAssisted Living Facility

Certificate Effective DateJune 13, 2025

Certificate Expiration DateJune 12, 2027

Laboratory DirectorMr. Doug Rusch

Laboratory Phone(503) 558-1215

Laboratory LocationPrinceton Village Assisted Living Community14370 SE Oregon Trail Drive, Clackamas, OR 97015

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARBOR PLACE SENIOR COMMUNITY LLC

Point of Service