Evergreen Washington Healthcare Whitman, L.L.C.
Organization Active NPI Skilled Nursing Facility · Colfax, WA
NPI 1265427397 · NPPES record last updated Jan 30, 2017
Key facts
- NPI
- 1265427397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- MTS-2312 (WA)
- Legal business name
- EVERGREEN WASHINGTON HEALTHCARE WHITMAN, L.L.C.
- Practice address
- 1150 W Fairview St
Colfax, WA 99111-9580 - Phone
- (509) 397-4603
- Fax
- (509) 397-9214
- NPI assigned
- Sep 14, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- EMPRES WASHINGTON HEALTHCARE, LLC
Authorized official
- Name
- Brent Weil
- Title
- Ceo and Manager
- Phone
- (360) 892-6628
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | MTS-2312 | WA | Yes |
Addresses
Primary practice location
1150 W Fairview St
Colfax, WA 99111-9580
Mailing address
4601 NE 77TH Ave
Suite 300
Vancouver, WA 98662-6736
Phone (360) 892-6628
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4112405 | Medicaid | WA |
Other names
- Whitman Health and Rehabilitation Center
Other providers in Colfax, WA
- County of Whitman
- Deacon'S Medical Equipment
- Dr Healthy Foot PLLC
- Bradyn Reis Ellis
- Elizabeth Breanna Evangelista
- Rebecca Ewing
- Sarah L Fielding
- Frances Wagner Counseling, LLC
- Harold Graeme French
- Elida Golob
All providers in Colfax, 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 Jan 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.