Pauline Flournoy, CARE GIVER

Individual provider Active NPI Adult Care Home Facility · Roy, WA

NPI 1508030180 · NPPES record last updated Apr 15, 2008

Key facts

NPI
1508030180
Entity type
Individual (NPI type 1)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
138000 (WA)
Practice address
28121 14TH Ave E
Roy, WA 98580
Phone
(253) 843-2989
Fax
(253) 843-3087
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
138000WAMDAdult Care Home Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 138000 WA Yes

Addresses

Primary practice location

28121 14TH Ave E
Roy, WA 98580

Mailing address

28121 14TH Ave E
Roy, WA 98580
Phone (253) 843-2989

Other names

  • Pauline Anderson Former name

Other providers in Roy, WA

All providers in Roy, WA · Adult Care Home Facility in Washington

Sources for this page

Verify at the official NPI Registry.