Organization
STATE OF WASHINGTON WASHINGTON SOLDIERS HOME
Active
Other names
WA Soldiers Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEAL KASHMAR (CFO)
(360) 725-2512
Entity
Organization
Contact information
Practice address
1301 ORTING-KAPOWSIN HIGHWAY, ORTING, WA 98360
(360) 725-4506
(360) 893-4590
Mailing address
1301 ORTING KAPOWSIN HWY E, ORTING, WA 98360
(360) 893-4506
(360) 893-4590
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400014
—
WA
01
—
4924785
NCPDP
WA
05
—
7130479
—
WA
Enumeration date
03/21/2007
Last updated
08/28/2018
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