Washington State Walla Walla Veterans Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WASHINGTON STATE WALLA WALLA VETERANS HOME

Practice address

92 Wainwright Drive
Walla Walla, WA 99362

Phone

(360) 895-4710

Fax

(360) 895-4453

NPI assigned

Jan 28, 2016

Last updated

Sep 28, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

WASHINGTON STATE DEPARTMENT OF VETERANS AFFAIRSAs reported in NPPES

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

Authorized official

Name

Mr. Terrance Westhoff

Title

Cfo

Phone

(360) 725-2171

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548627011. Details of each certification follow.

• CCN 505530 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 505530

Legal name

WASHINGTON STATE WALLA WALLA VETERANS HOME

Doing business as

EXPRESS HEALTHCARE PROFESSIONALS

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 5, 2018

Last certification

Dec 16, 2024

Beds

80

Ownership / control type

State

Multi-facility organization

Washington State Department of Veterans Affairs

Organization structure

GovernmentNon-profit

Incorporated

Feb 8, 2015 in WA

Enrollment address

92 Wainwright Dr
Walla Walla, WA 99362-3975

Nursing home name

WASHINGTON STATE WALLA WALLA VETERANS HOME

Listed as

Washington State Walla Walla Veterans HomeCCN 505530 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Government - State

Certified

Mar 5, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8077.4 residents per day on average

Penalties (3 years)

1Fines totaling $10,358

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jose Gomez Bautista, MD

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1508354010

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Department of Veterans Affairs Spokane Veterans Home

  dba Spokane Veterans Home

  • Skilled Nursing Facility
  • Spokane, WA
  • NPI 1851381032

  Washington State Department of Vete

  CMS ownership
• State of Washington Washington Soldiers Home

  • Skilled Nursing Facility
  • Orting, WA
  • NPI 1972594810

  Washington State Department of Vete

  CMS ownership
• State of Washington, Washington Veterans Homes

  dba WA Veterans Home

  • Skilled Nursing Facility
  • Port Orchard, WA
  • NPI 1538159702

  Washington State Department of Vete

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Gomez Bautista, MD

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1508354010
  NPD (past)
• Christopher K Jenkins, DO

  • Emergency Medicine Physician
  • Walla Walla, WA
  • NPI 1962495994
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jose Gomez Bautista, MD

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1508354010

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1548627011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 WAINWRIGHT DR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-520-9879",
            "fax_number": "360-895-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 WAINWRIGHT DRIVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "360-895-4710",
            "fax_number": "360-895-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON STATE WALLA WALLA VETERANS HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON STATE DEPARTMENT OF VETERANS AFFAIRS",
        "enumeration_date": "2016-01-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "WESTHOFF",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-725-2171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Waring, MD
• Jody Washburn
• Washington Odd Fellows Home
• Washington Odd Fellows Home
• Washington State Department of Corrections-Washington State Penitentia
• Michelle Watilo, OTR/L
• Jenna Rae Watts, RN
• Catelyn J Webber
• Bonny M Weed, RN
• Patricia Sue Weeks, M.A. CCC-S

• Skilled Nursing Facility in Walla Walla, WA
• Providers in Walla Walla, 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 Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.