Organization
AVALON CARE CENTER-RAYMOND LLC
Active
Other names
Willapa Harbor Health & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES KIRTON (CEO/CHAIRMAN)
(801) 596-8844
Entity
Organization
Contact information
Practice address
1100 JACKSON AVE, RAYMOND, WA 98577-3308
(360) 942-2424
(360) 942-5287
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-2927
(801) 325-0153
(801) 596-9001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH 1357
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113577
—
WA
Enumeration date
09/01/2005
Last updated
08/17/2022
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