# NORTHWEST CARE-ISSAQUAH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629265871
- **Authorized official:** MR. MARC JOHNSON (CFO)
- **Authorized official phone:** (949) 373-8373

## Contact information

- **Practice address:** 805 FRONT ST S, ISSAQUAH, WA 98027-4205
- **Practice address phone:** (425) 392-1271
- **Practice address fax:** (425) 557-5563
- **Mailing address:** 25910 ACERO STE 350, MISSION VIEJO, CA 92691-7908
- **Mailing address phone:** (949) 441-9258
- **Mailing address fax:** (949) 373-0358

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1407 | WA | Yes |

## Other

- **Enumeration date:** 10/02/2007
- **Last updated:** 04/05/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4114070 | — | WA |
| 01 | — | 505004 | MEDICARE PROVIDER NUMBER | WA |