# MARYVILLE NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285631036
- **Authorized official:** MRS. KATHLEEN PARRY (ADMINISTRATOR)
- **Authorized official phone:** (503) 643-8626

## Contact information

- **Practice address:** 14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
- **Practice address phone:** (503) 643-8626
- **Practice address fax:** (503) 520-1435
- **Mailing address:** 14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
- **Mailing address phone:** (503) 643-8626
- **Mailing address fax:** (503) 520-1435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | — | OR | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | OR | — |
| 314000000X | Skilled Nursing Facility | — | OR | — |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 09/11/2025