Organization
EVERGREENHEALTH AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS GERARD KULFAN COTA (CERTIFIED OCCUPATIONAL THERAPY ASSI)
(360) 689-5673
Entity
Organization
Contact information
Practice address
3517 11TH ST, BREMERTON, WA 98312-2633
(360) 475-0745
Mailing address
7680 VINEYARDS LN NE APT K302, BREMERTON, WA 98311-9255
(360) 689-5673
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OC00001206
WA
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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