Organization
NORTHWEST CARE-ISSAQUAH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC JOHNSON (CFO)
(949) 373-8373
Entity
Organization
Contact information
Practice address
805 FRONT ST S, ISSAQUAH, WA 98027-4205
(425) 392-1271
(425) 557-5563
Mailing address
25910 ACERO STE 350, MISSION VIEJO, CA 92691-7908
(949) 441-9258
(949) 373-0358
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1407
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4114070
—
WA
01
—
505004
MEDICARE PROVIDER NUMBER
WA
Enumeration date
10/02/2007
Last updated
04/05/2024
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