Organization
REVERE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYATT REX RODERICK (PRESIDENT)
(206) 605-8854
Entity
Organization
Contact information
Practice address
160 NW GILMAN BLVD STE 310, ISSAQUAH, WA 98027-2549
(425) 245-5540
(833) 239-7087
Mailing address
160 NW GILMAN BLVD STE 310, ISSAQUAH, WA 98027-2549
(425) 245-5540
(833) 239-7087
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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