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W2 POWELL VALLEY, LLC
NPI 1861092520
Assisted Living Facility in Gresham, OR

Active since October 30, 2020CLIA 38D2197499 · Waiver
4001 SE 182ND AVE, GRESHAM, OR 97030(503) 665-2496 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About W2 Powell Valley, Llc NPPES

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

W2 POWELL VALLEY, LLC (NPI 1861092520), doing business as Powell Valley Assisted Living Community, is a healthcare organization registered as an assisted living facility in Gresham, Oregon and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through October 25, 2026 and lists Trevor Wart, Manager, as its authorized official.

NPPES Registry Identity

NPI1861092520
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameW2 POWELL VALLEY, LLC
Location Address4001 SE 182ND AVEGresham, OR 97030-5063
Mailing Address4001 Se 182nd AveGresham, OR 97030-5063 · (503) 665-2496
Phone(503) 665-2496
Organization SubpartNo
Authorized OfficialTrevor WartManager · (503) 706-6918
Enumeration DateOctober 30, 2020
NPPES CertifiedOctober 30, 2020
✔ NPI 1861092520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
4001 SE 182ND AVE, Gresham, OR 97030
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Other Names 1

Doing Business AsPowell Valley 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 38D2197499

W2 Powell Valley, LLC · Gresham, OR
Active · expires Oct 25, 2026
CLIA Number38D2197499
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 26, 2024
Certificate Expiration DateOctober 25, 2026
Laboratory DirectorJadine A. Cabrera
Laboratory Phone(503) 706-6918
Laboratory LocationW2 Powell Valley, LLC4001 SE 182nd Avenue, Gresham, OR 97030
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 W2 Powell Valley, LLC's NPI number?

The NPI number for W2 Powell Valley, LLC is 1861092520. It was assigned to this organization in the NPPES registry on October 30, 2020. The provider is doing business as Powell Valley Assisted Living Community.

Where is W2 Powell Valley, LLC located?

W2 Powell Valley, LLC is located at 4001 SE 182nd Ave, Gresham, OR 97030. The listed phone number is (503) 665-2496.

What is W2 Powell Valley, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does W2 Powell Valley, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2197499) is associated with this NPI, valid through October 25, 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 W2 Powell Valley, LLC was last updated on October 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.