PENDLETON ALF, LLC
NPI 1770108052
Assisted Living Facility in Pendleton, OR

NPI Status: Active since June 11, 2020

Contact Information

301 SW 28TH DR
PENDLETON, OR
ZIP 97801
Phone: (541) 278-0666

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 38D0628506
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 12-31-2027

About PENDLETON ALF, LLC

This page provides the complete NPI Profile along with additional information for Pendleton Alf, Llc, a provider established in Pendleton, Oregon operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1770108052 assigned on June 2020. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Peter Verdieck (Evp Finance & Administration)

NPI
1770108052
Provider Name
PENDLETON ALF, LLC
Entity Type
Organization
Location Address
301 SW 28TH DR PENDLETON, OR 97801
Location Phone
(541) 278-0666
Mailing Address
15900 SE 82ND DR CLACKAMAS, OR 97015
Mailing Phone
(503) 255-4647
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-11-2020
Last Update Date
06-11-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

PETER VERDIECK

Authorized Official Title
EVP FINANCE & ADMINISTRATION
Authorized Official Phone
(503) 255-4647

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D0628506
Facility Type
Independent
Certificate Effective Date
January 01, 2026
Certificate Expiration Date
December 31, 2027
Laboratory Director
DR. JOEL S. BENTZ
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Pendleton Alf, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1770108052, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 1 → 2 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 2 + 0 + 1 + 6 + 0 + 1 + 0 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1770108052.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770108052, enumerated as an "organization" on June 11, 2020.

The provider is located at 301 SW 28TH DR PENDLETON, OR 97801 and the phone number is (541) 278-0666.

Assisted Living Facility with taxonomy code 310400000X.