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Organization
WASHINGTON ODD FELLOWS HOME
Active
Organization
WASHINGTON ODD FELLOWS HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R BRIGHAM (ADMINISTRATOR)
(509) 525-6463
Entity
Organization
Contact information
Practice address
534 BOYER AVENUE, WALLA WALLA, WA 99362
(509) 525-6463
(509) 526-6883
Mailing address
534 BOYER AVENUE, WALLA WALLA, WA 99362
(509) 525-6463
(509) 526-6883
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015156
—
WA
05
—
4135109
—
WA
Enumeration date
10/26/2005
Last updated
02/23/2011
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