Organization
EVERGREEN WASHINGTON HEALTHCARE MANOR, L.L.C.
Active
Other names
Evergreen Manor Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE L. PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
1330 11TH AVE, LONGVIEW, WA 98632-3817
(360) 425-6706
(360) 423-3002
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1226
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112264
—
WA
Enumeration date
05/05/2006
Last updated
07/07/2008
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