Organization
EVERGREEN WASHINGTON HEALTHCARE CENTRALIA, L.L.C.
Active
Other names
Evergreen Centralia Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DALE L. PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
1015 LONG RD, CENTRALIA, WA 98531-1038
(360) 736-3381
(360) 330-2901
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
1224
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112249
—
WA
Enumeration date
09/15/2005
Last updated
07/03/2008
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