# PACIFIC BREEZE AFH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043157324
- **Authorized official:** HABTE SIMON PHARMD (RESIDENT MANAGER)
- **Authorized official phone:** (360) 605-8930

## Contact information

- **Practice address:** 16017 NE 79TH WAY, VANCOUVER, WA 98682-1541
- **Practice address phone:** (360) 605-8930
- **Practice address fax:** (360) 251-0313
- **Mailing address:** 16017 NE 79TH WAY, VANCOUVER, WA 98682-1541
- **Mailing address phone:** (360) 605-8930
- **Mailing address fax:** (360) 251-0313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2026
- **Last updated:** 05/04/2026