Organization
RIDGEMONT TERRACE INC
Active
Organization
RIDGEMONT TERRACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E CHASTEEN (ADMINISTRATOR)
(360) 876-4461
Entity
Organization
Contact information
Practice address
2051 POTTERY AVE, PORT ORCHARD, WA 98366-2010
(360) 876-4461
(360) 876-4482
Mailing address
2051 POTTERY AVE, PORT ORCHARD, WA 98366-2010
(360) 876-4461
(360) 876-4482
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
NH588
WA
314000000X
Skilled Nursing Facility
NH588
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4158804
—
WA
Enumeration date
07/26/2005
Last updated
09/11/2025
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