| NPI | 1538154885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY A. FOX Health Information Manager 360-425-5910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WA 601765213) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-08-22 |