Organization
WILDERNESS SHORES NURSING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY ANN MCMONAGLE (ADMINISTRATOR)
(206) 931-5284
Entity
Organization
Contact information
Practice address
25614 LAKE WILDERNESS LN SE, MAPLE VALLEY, WA 98038-6019
(206) 931-5284
(425) 413-5116
Mailing address
25614 LAKE WILDERNESS LN SE, MAPLE VALLEY, WA 98038-6019
(206) 931-5284
(425) 413-5116
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IHS.FS.60055610
WA
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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