Eagle Healthcare at Camas

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1159 Issued in WA

Legal business name

EAGLE HEALTHCARE AT CAMAS

Doing business as

Eagle Rehabilitation at Camas

Practice address

640 NE Everett
Camas, WA 98607

Phone

(360) 834-5055

Fax

(360) 834-0504

NPI assigned

Oct 3, 2006

Organization subpart

Yes

Parent organization

EAGLE HEALTHCARE, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Curran Wong

Title

Corporate Services

Phone

(425) 285-3886

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eagle Rehabilitation at Camas Doing business as

Part of

Eagle Healthcare at Camas

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1306931944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 NE DALLAS ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "telephone_number": "425-285-3891",
            "fax_number": "425-285-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NE EVERETT",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "telephone_number": "360-834-5055",
            "fax_number": "360-834-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE AT CAMAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTHCARE, INC",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CURRAN",
        "authorized_official_title_or_position": "CORPORATE SERVICES",
        "authorized_official_telephone_number": "425-285-3886"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111597",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Rehabilitation at Camas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summer Nichole Dowell, LMP
• Samuel Duffey
• Diedra Dulaney, LMP
• Tiffanie Marie Duley, RHIT
• Emily Duquette, DPT
• James Eastman
• Patricia M Edmundson, MA
• Alexa Efraimson, MS, RD
• Christina Elliott, DPT
• Sarah-Denise Khalid Elolaimi

• Skilled Nursing Facility in Camas, WA
• Providers in Camas, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.