# MARTHA AND MARY HEALTH SERVICES

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

## Provider details

- **NPI number:** 1710988753
- **Authorized official:** MS. LYNETTE L LADENBURG (CEO)
- **Authorized official phone:** (360) 779-7500

## Contact information

- **Practice address:** 19160 FRONT ST NE, POULSBO, WA 98370-0127
- **Practice address phone:** (360) 779-7500
- **Mailing address:** 19160 FRONT ST NE, PO BOX 127, POULSBO, WA 98370-0127
- **Mailing address phone:** (360) 779-7500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1216 | WA | Yes |

## Other

- **Enumeration date:** 08/01/2005
- **Last updated:** 06/01/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1216 | NURSING HOME LICENSE | WA |
| 05 | — | 4112165 | — | WA |