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Organization
GEORGIAN REHAB, LLC
Active
Organization
GEORGIAN REHAB, LLC
Active
Other names
Avamere Transitional Care of Puget Sound
Organization subpart
No
Provider details
NPI number
Authorized official
KARL MILLER JR. (CEO)
(503) 570-3405
Entity
Organization
Contact information
Practice address
630 S PEARL ST, TACOMA, WA 98465-2111
(253) 671-7300
Mailing address
25117 SW PARKWAY AVE, SUITE F, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-5529
MEDICARE OSCAR
WA
Enumeration date
02/02/2007
Last updated
01/21/2025
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