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Organization
EVERGREEN WASHINGTON HEALTHCARE CENTRALIA, L.L.C.
Active
Organization
EVERGREEN WASHINGTON HEALTHCARE CENTRALIA, L.L.C.
Active
Other names
Evergreen Centralia Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DALE L. PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
1015 LONG RD, CENTRALIA, WA 98531-1038
(360) 736-3381
(360) 330-2901
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
1224
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112249
—
WA
Enumeration date
09/15/2005
Last updated
07/03/2008
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