Organization
PACIFIC NORTHWEST CARE, LLC.
Active
Organization
PACIFIC NORTHWEST CARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH JAY VANDERDOES (GOVERNOR)
(360) 710-7067
Entity
Organization
Contact information
Practice address
29252 SCENIC DR NE, POULSBO, WA 98370-9327
(360) 360-2350
Mailing address
19689 7TH AVE NE # 339, POULSBO, WA 98370-8091
(360) 710-7067
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
06/10/2024
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