# NORTH LAKE 5-O, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shoreline Health and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447647482
- **Authorized official:** BRIAN NEWBERRY (MANAGER)
- **Authorized official phone:** (801) 899-5364

## Contact information

- **Practice address:** 2818 NE 145TH ST, SHORELINE, WA 98155-7556
- **Practice address phone:** (206) 418-2900
- **Mailing address:** 2818 NE 145TH ST, SHORELINE, WA 98155-7556
- **Mailing address phone:** (206) 418-2900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1421 | WA | Yes |

## Other

- **Enumeration date:** 04/16/2015
- **Last updated:** 07/13/2015