Eagle Healthcare, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1310 Issued in WA

Legal business name

EAGLE HEALTHCARE, INC

Doing business as

Parkside Nursing Care Center

Practice address

308 W Emma St
Union Gap, WA 98903-1940

Phone

(509) 248-1985

Fax

(509) 248-0681

NPI assigned

Oct 9, 2006

Last updated

Dec 9, 2008By the provider in NPPES

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

Mr. Greg Schmidt

Title

Controller

Phone

(425) 285-3891

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PARKSIDE NURSING CARE CENTER Doing business as

Part of

Eagle Assisted Living

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1316034473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12015 115TH AVE NE # E195",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346940",
            "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": "308 W EMMA ST",
            "city": "UNION GAP",
            "state": "WA",
            "postal_code": "989031940",
            "telephone_number": "509-248-1985",
            "fax_number": "509-248-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTHCARE, INC",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "425-285-3891",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113106",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKSIDE NURSING CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annika Crumrine-Hammer, SLPA-C
• Derek Thompson DMD Patrick Ferguson DDS (Apple Valley Dental and Orthodontics)
• Derek Thompson DMD Patrick Ferguson DDS PLLC (Yakima Family Dental)
• Maria Dolores Dominguez
• Doug Ricks and Associates
• Richard D Edgerly, MD
• Christina Ryan Eglin, MD
• Miguel A Espinoza
• Jennifer Frances Felix, PHARMACIST
• Patricia Beryl Fendall-Sutphen

• Skilled Nursing Facility in Union Gap, WA
• Providers in Union Gap, 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 Dec 9, 2008; 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.