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MARYVILLE NURSING HOME
NPI 1285631036
Alzheimer Center (Dementia Center) in Beaverton, OR

Active since July 07, 2005CLIA 38D0621740 · Waiver
14645 SW FARMINGTON RD, BEAVERTON, OR 97007(503) 643-8626(503) 520-1435 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Maryville Nursing Home NPPES

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

MARYVILLE NURSING HOME (NPI 1285631036) is a healthcare organization registered as an alzheimer center (dementia center) in Beaverton, Oregon and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through December 31, 2027 and lists Kathleen Parry, Administrator, as its authorized official.

NPPES Registry Identity

NPI1285631036
Entity TypeOrganization
Primary Taxonomy311500000X
Legal Business NameMARYVILLE NURSING HOME
Location Address14645 SW FARMINGTON RDBeaverton, OR 97007-2727
Mailing Address14645 Sw Farmington RdBeaverton, OR 97007-2727 · (503) 643-8626 · Fax (503) 520-1435
Phone(503) 643-8626
Fax(503) 520-1435
Organization SubpartNo
Authorized OfficialKathleen ParryAdministrator · (503) 643-8626
Enumeration DateJuly 7, 2005
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1285631036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities
Taxonomy Code311500000X
Definition
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X
Also ListedSkilled Nursing FacilityTaxonomy 314000000X
14645 SW FARMINGTON RD, Beaverton, OR 97007
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Other Identifiers 1

Medicaid806745OR

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 38D0621740

Maryville Nursing Home Laboratory · Beaverton, OR
Active · expires Dec 31, 2027
CLIA Number38D0621740
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorKathleen Parry
Laboratory Phone(503) 643-8626
Laboratory LocationMaryville Nursing Home Laboratory14645 SW Farmington Rd, Beaverton, OR 97007
CLIA data matches this NPI record on: Address Name 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.

JAYLI CHIEKO MIYAMOTO
Physical Therapy Assistant
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
MRS. NAOMI J BEALE MS SLP
Speech-Language Pathologist
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
AKEAKAMAI ROSE
Occupational Therapy Assistant
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
JORDAN HORNER M.S. SLP
Speech-Language Pathologist
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
EMILY KOZLOWSKI COTA
Occupational Therapy Assistant
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
ALLY LI WADA WONG
Physical Therapist
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
AMY M CZUPRYN PTA
Physical Therapy Assistant
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626
KATIE MANSOURA
Speech-Language Pathologist
14645 SW FARMINGTON RD
BEAVERTON, OR 97007
Washington County (503) 643-8626

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryville Nursing Home's NPI number?

The NPI number for Maryville Nursing Home is 1285631036. It was assigned to this organization in the NPPES registry on July 7, 2005.

Where is Maryville Nursing Home located?

Maryville Nursing Home is located at 14645 SW Farmington Rd, Beaverton, OR 97007. The listed phone number is (503) 643-8626.

What is Maryville Nursing Home's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Maryville Nursing Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0621740) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Maryville Nursing Home was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.