Organization
COVENANT LIVING WEST
Active
Other names
Covenant Shores Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MALZAHN (VICE PRESIDENT OF HEALTH SERVICES)
(773) 878-4430
Entity
Organization
Contact information
Practice address
9107 FORTUNA DR, MERCER ISLAND, WA 98040-3132
(206) 268-3000
(206) 236-1438
Mailing address
9150 FORTUNA DRIVE, MERCER ISLAND, WA 98040-3133
(206) 268-3000
(206) 236-1438
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1231
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112314
—
WA
Enumeration date
10/20/2006
Last updated
07/30/2019
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