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PONDEROSA RETIREMENT CENTER INC. NPI 1407360936


NPI Information

NPI: 1407360936
Provider Name: PONDEROSA RETIREMENT CENTER INC.
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 50D2267109

Address:
3300 ENGLEWOOD AVE
YAKIMA, WA
ZIP 98902
Phone: (509) 453-1366
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PONDEROSA RETIREMENT CENTER INC. is an assisted living facility in Yakima, WA. The provider is 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. PONDEROSA RETIREMENT CENTER INC. NPI is 1407360936. The provider is registered as an organization entity type.

The provider's business location address is:

3300 ENGLEWOOD AVE
YAKIMA, WA
ZIP 98902-517
Phone: (509) 453-1366
Fax: (509) 452-4907

The provider's authorized official is Tina Michelle Moss .
The authorized official title is Administrator and has the following contact phone number (509) 453-1366.

The CLIA number assigned to this NPI record is 50D2267109 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/20/2017 and was last updated on 11/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityWASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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