Organization
PACIFIC GARDENS ESTATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT M. EMRY BHA, NHA (VICE PRESIDENT OF OPERATIONS)
(503) 585-0200
Entity
Organization
Contact information
Practice address
14145 SW 105TH AVE, TIGARD, OR 97224-4808
(503) 639-1144
(503) 620-7201
Mailing address
PO BOX 3548, SALEM, OR 97302-0548
(503) 585-0200
(503) 585-1268
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38A030
—
OR
Enumeration date
03/28/2006
Last updated
08/22/2020
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