Provider Demographics
NPI:1215567102
Name:TIMBER RIDGE OPCO LLC
Entity Type:Organization
Organization Name:TIMBER RIDGE OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4527
Mailing Address - Street 1:100 TIMBER RIDGE WAY NW
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8890
Mailing Address - Country:US
Mailing Address - Phone:425-427-5200
Mailing Address - Fax:425-427-5207
Practice Address - Street 1:100 TIMBER RIDGE WAY NW
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8890
Practice Address - Country:US
Practice Address - Phone:425-427-5200
Practice Address - Fax:425-427-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility