{"npi":"1487602173","type":"NPI-2","status":"active","name":{"display":"Evergreen Oregon Healthcare Valley Vista, L.L.C.","other":[],"organization_name":"EVERGREEN OREGON HEALTHCARE VALLEY VISTA, L.L.C.","authorised_official":"Brent Weil"},"specialty":{"primary_taxonomy":"314000000X","primary_taxonomy_description":"Skilled Nursing Facility","slug":"skilled-nursing-facility","schema_org_specialty":null,"all":[{"code":"314000000X","description":"Skilled Nursing Facility","primary":true,"state":"OR","license":"1668"}]},"addresses":[{"purpose":"LOCATION","street_1":"1023 W 25TH ST","city":"THE DALLES","state":"OR","postal_code":"970581251","country_code":"US","phone":"5412985158","fax":"5412983864"},{"purpose":"MAILING","street_1":"4601 NE 77TH AVE","city":"VANCOUVER","state":"WA","postal_code":"986626736","country_code":"US","street_2":"SUITE 300","phone":"3608926628","fax":"3608825793"}],"license":{"state":"OR","number":"1668"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"801055","state":"OR","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-05-04","last_updated":"2017-01-30","_meta":{"source":"NPPES","snapshot_date":"2017-01-30","doc_url":"https://findmynpi.com/api"}}