Organization
2021 BOULEVARD COHOUSING LLC
Active
Other names
2021 Boulevard
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL IRWIN STUSSER (MANAGING PARTNER)
(360) 259-5000
Entity
Organization
Contact information
Practice address
2021 BOULEVARD RD SE, OLYMPIA, WA 98501-3227
(360) 259-5000
(360) 357-7049
Mailing address
PO BOX 4008, OLYMPIA, WA 98501-0008
(360) 259-5000
(360) 357-7049
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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