Eagle Healthcare, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1115 Issued in WA

Legal business name

EAGLE HEALTHCARE, INC

Doing business as

Pinehurst Park Terrace

Practice address

2818 NE 145TH St
Shoreline, WA 98155-7556

Phone

(206) 364-8810

Fax

(206) 417-8400

NPI assigned

Nov 7, 2005

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

• PINEHURST PARK TERRACE Doing business as

Part of

Eagle Healthcare at Camas

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1649251653",
    "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": "2818 NE 145TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557556",
            "telephone_number": "206-364-8810",
            "fax_number": "206-417-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTHCARE, INC",
        "enumeration_date": "2005-11-07",
        "last_updated": "2009-01-20",
        "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": "1115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111159",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINEHURST PARK TERRACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Duggan
• Alexander Dutton
• Henri Frederik Duyzend
• Elise Dziko, MOT
• E. Charmaine Barizo, DDS PLLC
• Douglas Benjamin Eakin, P.T.A.
• Kara R Edson, MS, LMHC
• Lexus Michelle Edwards
• Efl Education
• Carolyn Egan, L.AC

• Skilled Nursing Facility in Shoreline, WA
• Providers in Shoreline, 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 Jan 20, 2009; 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.