Organization
MAPLE CREEK VENTURE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL MASON (DIRECTOR OF OPERATIONS)
(503) 826-5190
Entity
Organization
Contact information
Practice address
10420 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-5041
(253) 588-0227
Mailing address
25260 SW PARKWAY AVE STE B, WILSONVILLE, OR 97070-6627
(503) 826-5190
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604-693-222
UBI
WA
Enumeration date
02/01/2021
Last updated
02/01/2021
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