# BETHANY OF THE NORTHWEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethany at Pacific
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003879800
- **Authorized official:** JOSEPH SCRIVENS (CEO)
- **Authorized official phone:** (425) 551-6400

## Contact information

- **Practice address:** 916 PACIFIC AVENUE, EVERETT, WA 98201
- **Practice address phone:** (425) 259-5508
- **Practice address fax:** (425) 258-5656
- **Mailing address:** PO BOX 13700, MILL CREEK, WA 98082-1700
- **Mailing address phone:** (425) 332-4475
- **Mailing address fax:** (425) 740-0426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 313007682 | WA | Yes |

## Other

- **Enumeration date:** 04/11/2006
- **Last updated:** 07/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4112900 | — | WA |