State of Washington Washington Soldiers Home
Organization Active NPI Skilled Nursing Facility · Orting, WA
NPI 1174648604 · NPPES record last updated Aug 28, 2018
Key facts
- NPI
- 1174648604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- STATE OF WASHINGTON WASHINGTON SOLDIERS HOME
- Practice address
- 1301 Orting-Kapowsin Highway
Orting, WA 98360 - Phone
- (360) 725-4506
- Fax
- (360) 893-4590
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Micheal Kashmar
- Title
- Cfo
- Phone
- (360) 725-2512
Other NPIs on the same Medicare enrollment 1
Practitioners 4
-
Michelle Ray, PH
-
Cheryl L. Wright, RD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310000421 | WA | Part B Supplier - Clinic/Group Practice | 6103734587 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Orting, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes | ||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
1301 Orting-Kapowsin Highway
Orting, WA 98360
Mailing address
1301 Orting Kapowsin Hwy E
Orting, WA 98360
Phone (360) 893-4506
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400014 | Medicaid | WA | |
| 4924785 | Other | WA | NCPDP |
| 7130479 | Medicaid | WA |
Other names
- WA Soldiers Home
Other providers in Orting, WA
- Martha Schneider
- Jessica Schroeder
- Serendipity Healing Arts Center LLC
- SMC Nursing, LLC
- Rajwinder Sran
- State of Washington Washington Soldiers Home
- Danielle Steinmetz
- Catherine Elizabeth Taylor
- The Speech & Language Tree, PLLC
- Bridget Thompson
All providers in Orting, WA · Skilled Nursing Facility in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.