# EVERGREEN KITSAP, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EMPRES WASHINGTON HEALTHCARE, LLC
- **Other names:** Northwoods Lodge
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336686914
- **Legal business name:** EMPRES WASHINGTON HEALTHCARE, LLC
- **Authorized official:** BRENT WEIL (CEO AND MANAGER)
- **Authorized official phone:** (360) 604-4217

## Contact information

- **Practice address:** 2321 NW SCHOLD PL, SILVERDALE, WA 98383-9504
- **Practice address phone:** (360) 698-8930
- **Mailing address:** 4601 NE 77TH AVE STE 300, VANCOUVER, WA 98662-6736
- **Mailing address phone:** (360) 604-4217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/20/2017
- **Last updated:** 01/20/2017