# STATE OF WASHINGTON, WASHINGTON VETERANS HOMES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WA Veterans Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538159702
- **Authorized official:** MR. TERRANCE WESTHOFF (CFO)
- **Authorized official phone:** (360) 725-2152

## Contact information

- **Practice address:** 1141 BEACH DR E, PORT ORCHARD, WA 98366-4937
- **Practice address phone:** (360) 895-4700
- **Practice address fax:** (360) 895-4453
- **Mailing address:** 1141 BEACH DR E, PORT ORCHARD, WA 98366-4937
- **Mailing address phone:** (360) 895-4700
- **Mailing address fax:** (360) 895-4453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | N/A | WA | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | N/A | WA | — |
| 314000000X | Skilled Nursing Facility | NOT APPLICABLE | WA | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 10/23/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4000006 | — | WA |
| 01 | — | 50-5517 | MEDICARE A | — |
| 05 | — | 7102411 | — | WA |