| NPI | 1033119649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD E CHASTEEN Administrator 360-876-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WA NH588) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA NH588) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2020-08-22 |