# COVENANT LIVING WEST

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Covenant Shores Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023190824
- **Authorized official:** ELIZABETH MALZAHN (VICE PRESIDENT OF HEALTH SERVICES)
- **Authorized official phone:** (773) 878-4430

## Contact information

- **Practice address:** 9107 FORTUNA DR, MERCER ISLAND, WA 98040-3132
- **Practice address phone:** (206) 268-3000
- **Practice address fax:** (206) 236-1438
- **Mailing address:** 9150 FORTUNA DRIVE, MERCER ISLAND, WA 98040-3133
- **Mailing address phone:** (206) 268-3000
- **Mailing address fax:** (206) 236-1438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1231 | WA | Yes |

## Other

- **Enumeration date:** 10/20/2006
- **Last updated:** 07/30/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4112314 | — | WA |