Provider Demographics
NPI:1881210243
Name:SPRING RIDGE RETIREMENT, LLC
Entity Type:Organization
Organization Name:SPRING RIDGE RETIREMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-344-6065
Mailing Address - Street 1:1800 BLANKENSHIP RD STE 475
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4248
Mailing Address - Country:US
Mailing Address - Phone:033-446-0655
Mailing Address - Fax:
Practice Address - Street 1:6856 E PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-3421
Practice Address - Country:US
Practice Address - Phone:503-344-6065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)