Organization
NORTH LAKE 5-O, LLC
Active
Other names
Shoreline Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN NEWBERRY (MANAGER)
(801) 899-5364
Entity
Organization
Contact information
Practice address
2818 NE 145TH ST, SHORELINE, WA 98155-7556
(206) 418-2900
Mailing address
2818 NE 145TH ST, SHORELINE, WA 98155-7556
(206) 418-2900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1421
WA
Other
Enumeration date
04/16/2015
Last updated
07/13/2015
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