Extendicare North Auburn Rehabilitation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

OC60282758 Issued in WA

Legal business name

EXTENDICARE NORTH AUBURN REHABILITATION

Doing business as

Prostep Rehabilitation

Practice address

2830 I St NE
Auburn, WA 98002-2410

Phone

(253) 561-8100

Fax

(253) 333-1718

NPI assigned

Nov 2, 2013

Organization subpart

Yes

Parent organization

EXTENDICAREAs reported in NPPES

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

Authorized official

Name

Mrs. Tenisha Chesney

Title

Certified Occupational Therapy Asst

Phone

(206) 229-7418

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Prostep Rehabilitation Doing business as

Part of

Belair Nursing Home

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1730518531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 I ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980022410",
            "telephone_number": "253-561-8100",
            "fax_number": "253-333-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 I ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980022410",
            "telephone_number": "253-561-8100",
            "fax_number": "253-333-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDICARE NORTH AUBURN REHABILITATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXTENDICARE",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "CHESNEY",
        "authorized_official_first_name": "TENISHA",
        "authorized_official_title_or_position": "CERTIFIED OCCUPATIONAL THERAPY ASST",
        "authorized_official_telephone_number": "206-229-7418",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "OC60282758",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "OC60282758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811061518",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prostep Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cidney Jordan Evanson
• Evergreen Eye Center, PLLC
• Evergreen Psychiatry PLLC
• Evergreen Washington Healthcare Auburn, L.L.C.
• Kelsey Joan Evins, ATC
• Sherese Danielle Ezelle
• Vinesa Faaogea-Kabui
• Emily Faber
• Sarah Faison
• Faith House Afh LLC

• Skilled Nursing Facility in Auburn, WA
• Providers in Auburn, 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 Nov 2, 2013; 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.