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Organization
STATE OF WASHINGTON WASHINGTON SOLDIERS HOME
Active
Organization
STATE OF WASHINGTON WASHINGTON SOLDIERS HOME
Active
Other names
WA Soldiers Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEAL KASHMAR (CFO)
(360) 725-2512
Entity
Organization
Contact information
Practice address
1301 ORTING-KAPOWSIN HIGHWAY, ORTING, WA 98360
(360) 725-4506
(360) 893-4590
Mailing address
1301 ORTING KAPOWSIN HWY E, ORTING, WA 98360
(360) 893-4506
(360) 893-4590
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400014
—
WA
01
—
4924785
NCPDP
WA
05
—
7130479
—
WA
Enumeration date
03/21/2007
Last updated
08/28/2018
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