Waatu, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1314 Issued in WA

Legal business name

WAATU, INC.

Practice address

1530 James St
Bellingham, WA 98225-4945

Phone

(360) 733-9161

Fax

(360) 715-1948

NPI assigned

Feb 27, 2017

Organization subpart

No

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

Authorized official

Name

David Kiefer

Title

VP Cfo

Phone

(360) 293-3174

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shuksan Healthcare Center Doing business as

Locations

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1922548825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 27TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212710",
            "telephone_number": "360-293-3174",
            "fax_number": "360-293-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 JAMES ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254945",
            "telephone_number": "360-733-9161",
            "fax_number": "360-715-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAATU, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "KIEFER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP CFO",
        "authorized_official_telephone_number": "360-293-3174"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113148",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shuksan Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Jean Vredevoogd
• W Douglas Uhl
• David Kristoffer Waade
• Eirin C Waade, ARNP
• Morgan Waage
• Rebecca Dawn Waggoner I, M.S.C.P. CANDIDATE
• Jason Philip Wagner, RN
• Lee James Wagner Jr., N.D.
• Mary Ann Wagner
• Nicole Marie Wagner, SUDPT

• Skilled Nursing Facility in Bellingham, WA
• Providers in Bellingham, 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, 2017; 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.