PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY
NPI 1275746414
Point of Service in Salem, OR

Q: What is Park Vista Retirement & Assisted Living Community LLC's specialty?

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

Active since May 07, 2007CLIA 50D2254859 · Waiver

3220 STATE ST, SUITE 200, SALEM, OR 97301(506) 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: August 09, 2026.

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About Park Vista Retirement & Assisted Living Community NPPES

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

PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY (NPI 1275746414) 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 April 4, 2028 and lists Kelley D Hamilton, Ceo-pres Of Manager, as its authorized official.

NPPES Registry Identity

NPI1275746414

Entity TypeOrganization

Primary Taxonomy305S00000X

Legal Business NamePARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC

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

Mailing Address2944 Se Lund AvePort Orchard, WA 98366-5547 · (360) 871-2323 · Fax (360) 871-2521

Phone(506) 566-5715

Fax(503) 588-3531

Organization SubpartNo

Authorized OfficialKelley D HamiltonCeo-pres Of Manager · (506) 566-5715

Enumeration DateMay 7, 2007

Last NPPES UpdateOctober 4, 2007

✔ NPI 1275746414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations

Taxonomy Code305S00000X

License✔ Licensed in WA · 1810

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 AsPark Vista Retirement & Assisted Living Community

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 50D2254859

Park Vista Retirement And Assisted Living Community · Port Orchard, WA

Active · expires Apr 4, 2028

CLIA Number50D2254859

Laboratory TypeAssisted Living Facility

Certificate Effective DateMarch 8, 2022

Certificate Expiration DateApril 4, 2028

Laboratory DirectorNicole Brophy

Laboratory Phone(360) 871-2323

Laboratory LocationPark Vista Retirement And Assisted Living Community2944 SE Lund Ave, Port Orchard, WA 98366

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.

ROSEBURG ASSISTED LIVING LLC

Point of Service