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Organization
VINTAGE ADULT FAMILY HOME LLC
Active
Organization
VINTAGE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE W. WAMWAKI RN (CO-OWNER)
(253) 317-3676
Entity
Organization
Contact information
Practice address
9111 FOREST AVE SW, LAKEWOOD, WA 98498-3523
(253) 317-3676
Mailing address
9111 FOREST AVE SW, LAKEWOOD, WA 98498-3523
(253) 317-3676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
10/16/2024
Last updated
10/21/2024
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