Crestwood Convalescent - Port Angeles LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CRESTWOOD CONVALESCENT - PORT ANGELES LLC

Practice address

1116 E Lauridsen Blvd
Port Angeles, WA 98362-6640

Phone

(360) 452-9206

NPI assigned

Nov 15, 2017

Organization subpart

No

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

Authorized official

Name

Chaim Wolmark

Title

Ceo

Phone

(253) 251-9081

Specialties & licenses 1

Addresses

Other names 1

• Olympic View Care Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neel Ramesh Chheda, DO

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1336678382
  NPD (past)
• Kaylesh K. Pandya, D.O.

  • Family Medicine Physician
  • Shelton, WA
  • NPI 1477998599
  NPD (past)
• Lusana Schutz, DO

  • Emergency Medicine Physician
  • Port Angeles, WA
  • NPI 1972731628
  NPD (past)

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1871006601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 ROSEDALE ST NW STE 200",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 E LAURIDSEN BLVD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626640",
            "telephone_number": "360-452-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD CONVALESCENT - PORT ANGELES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "WOLMARK",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-251-9081"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympic View Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phyllis Anne Cowan, DO
• Robert W Craven, M.D.
• Alan Crawford, RN
• Robin Lynn Crenshaw
• Crestwood Convalescent - Port Angeles LLC
• Carla Cribb, RN
• Samuel Dalton Crocco, DMD
• Dena Crosby, LPC, LMHP
• Timothy Crowley, RPH
• Pamela Cunningham

• Skilled Nursing Facility in Port Angeles, WA
• Providers in Port Angeles, 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 Feb 27, 2024; 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.