| NPI | 1629165881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI R WEAVER Billing Supervisor 509-535-2906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WA IS-202) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |