Mavericks Beach, LLC
Mavericks Beach, LLC is a healthcare organization registered as Skilled Nursing Facility in Saint Helens, OR, holding Type 2 (organization) NPI 1649077405 since 2025. The authorized official on file is Ryan Williams, Managing Member.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1649077405 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mavericks Beach, LLC |
| Practice address | 75 SHORE DR, Saint Helens, OR, 97051 |
| Phone | 5033972713 |
| Enumeration date | 2025-02-28 |
| Last updated in NPPES | 2025-02-28 |
Authorized official
| Name | Ryan Williams |
|---|---|
| Title | Managing Member |
| Phone | 9162997030 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | Primary | — | — |
Copy-ready billing details
Provider: Mavericks Beach, LLC NPI: 1649077405 Taxonomy: 314000000X (Skilled Nursing Facility) Address: 75 SHORE DR, Saint Helens, OR, 97051
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1649478710 | Jill Ralston | Individual | Physical Therapist | Saint Helens, OR |
| 1235338757 | Progressive Step Rehabilitation | Organization | Nursing Facility/Intermediate Care Facility | Saint Helens, OR |
| 1801096177 | Brittany Best | Individual | Speech-Language Pathologist | Saint Helens, OR |
| 1669800926 | Jennifer Murphy | Individual | Physical Therapist | Saint Helens, OR |
| 1265862247 | Barbara Travis | Individual | Skilled Nursing Facility | Saint Helens, OR |
| 1417387945 | Jacquelyn Matthews | Individual | Speech-Language Pathologist | Saint Helens, OR |
| 1225427032 | Fmg Shore Drive Oregon LLC | Organization | Skilled Nursing Facility | Saint Helens, OR |
| 1124415716 | Jeff Conn | Individual | Speech-Language Pathologist | Saint Helens, OR |
Verify this record
Cross-check NPI 1649077405 against the authoritative CMS record: view Mavericks Beach, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Mavericks Beach, LLC?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-02-28.