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PARKSIDE LIVING RTF
NPI 1447405147
Community Based Residential Treatment Facility, Mental Illness in Mcminnville, OR

Active since November 21, 2008CLIA 38D2269025 · Waiver
1525 SW SHIRLEY ANN DR, MCMINNVILLE, OR 97128(503) 472-9603 Get Directions Write a Review

NPPES record last updated: November 21, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Parkside Living Rtf NPPES

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

PARKSIDE LIVING RTF (NPI 1447405147) is a healthcare organization registered as a community based residential treatment facility, mental illness in Mcminnville, Oregon and active in the NPI registry since November 2008. The organization holds a CLIA Waiver certificate valid through September 19, 2026 and lists Pooneh Entezari, Owner, as its authorized official.

NPPES Registry Identity

NPI1447405147
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NamePARKSIDE LIVING RTF
Location Address1525 SW SHIRLEY ANN DRMcminnville, OR 97128-7665
Mailing Address139 N Lotus Beach DrPortland, OR 97217-8021 · (503) 309-6202
Phone(503) 472-9603
Organization SubpartNo
Authorized OfficialPooneh EntezariOwner · (503) 309-6202
Enumeration DateNovember 21, 2008
✔ NPI 1447405147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
1525 SW SHIRLEY ANN DR, Mcminnville, OR 97128
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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 38D2269025

Parkside Living Inc · Mcminnville, OR
Active · expires Sep 19, 2026
CLIA Number38D2269025
Laboratory TypeResidential Care Facility
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorAlyssa Pettibone
Laboratory Phone(503) 472-9603
Laboratory LocationParkside Living Inc1525 SW Shirley Ann Drive, Mcminnville, OR 97128
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 13

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

SARAH C. SEVERSON B.A.
Case Manager/Care Coordinator
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-4055
FRANK E HUSTON
Counselor (Mental Health)
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-4055
MCKENNA ROSE JAQUES
Counselor (Mental Health)
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-4055
MR. CESAR GARCIA
Counselor (Mental Health)
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-9603
CHRISTINE CAZARES
Counselor (Mental Health)
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 798-3783
DAWN R HALL RN
Registered Nurse
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-9603
ELEAZAR JR. AGUILERA-REYES
Counselor (Mental Health)
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (503) 472-9603
STEPHANIE ARCIGA
Case Manager/Care Coordinator
1525 SW SHIRLEY ANN DR
MCMINNVILLE, OR 97128
Yamhill County (971) 267-6391

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 Parkside Living Rtf's NPI number?

The NPI number for Parkside Living Rtf is 1447405147. It was assigned to this organization in the NPPES registry on November 21, 2008.

Where is Parkside Living Rtf located?

Parkside Living Rtf is located at 1525 SW Shirley Ann Dr, Mcminnville, OR 97128. The listed phone number is (503) 472-9603.

What is Parkside Living Rtf's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Parkside Living Rtf hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2269025) is associated with this NPI, valid through September 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Parkside Living Rtf was last updated on November 21, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.