Eagle Healthcare, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

601343205 Issued in WA

Legal business name

EAGLE HEALTHCARE, INC

Practice address

1036 E Victoria Ave
Burlington, WA 98233-1623

Phone

(360) 755-0711

Fax

(360) 755-0021

NPI assigned

Sep 29, 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

Mr. Greg Schmidt

Title

Controller

Phone

(425) 285-3891

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BURTON CARE CENTER Doing business as

Part of

Eagle Healthcare at Camas

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1679665269",
    "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": "1036 E VICTORIA AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331623",
            "telephone_number": "360-755-0711",
            "fax_number": "360-755-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTHCARE, INC",
        "enumeration_date": "2006-09-29",
        "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": "601343205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4112934",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BURTON CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael R Dillard, MD
• Stephanie R Dodd
• Julie Anna Doster Dodge, LMHC, ATR-P, MA
• Sara Dossen, RN
• Charvet Drucker, M.ED., BCBA
• Stuart Eagleburger
• Joseph Robert Eidsness, DDS
• Michael C Eubanks, D.M.D.
• Danielle Evans, BA
• Evergreen Recovery Centers

• Skilled Nursing Facility in Burlington, WA
• Providers in Burlington, 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.