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Organization
EVERGREEN KITSAP, L.L.C.
Active
Organization
EVERGREEN KITSAP, L.L.C.
Active
Parent organization
EVERGREEN WASHINGTON HEALTHCARE, L.L.C.
Other names
Kitsap Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN WASHINGTON HEALTHCARE, L.L.C.
Authorized official
MR. DALE L. PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
3517 11TH ST, BREMERTON, WA 98312-2633
(360) 377-5537
(360) 405-0537
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1367
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1367
STATE NURSING HOME NUMBER
WA
05
—
4111407
—
WA
Enumeration date
09/15/2005
Last updated
06/03/2011
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