# EVERGREENHEALTH AND REHAB

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

## Provider details

- **NPI number:** 1689840050
- **Authorized official:** MR. THOMAS GERARD KULFAN COTA (CERTIFIED OCCUPATIONAL THERAPY ASSI)
- **Authorized official phone:** (360) 689-5673

## Contact information

- **Practice address:** 3517 11TH ST, BREMERTON, WA 98312-2633
- **Practice address phone:** (360) 475-0745
- **Mailing address:** 7680 VINEYARDS LN NE APT K302, BREMERTON, WA 98311-9255
- **Mailing address phone:** (360) 689-5673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | OC00001206 | WA | Yes |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 05/05/2008