Organization
VIERCK LTD
Active
Other names
Canyon Creek Adult Family Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN DAVID VIERCK RN (PRESIDENT)
(360) 907-3997
Entity
Organization
Contact information
Practice address
22918 NE 169TH ST, BRUSH PRAIRIE, WA 98606-8716
(360) 907-3997
Mailing address
22918 NE 169TH ST, BRUSH PRAIRIE, WA 98606-8716
(360) 907-3997
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
456900
WA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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