MEDICARE: WESLEY HOMES DES MOINES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	1096	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568450807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESLEY HOMES DES MOINES LLC

Provider Business Mailing Address
First Line	:	32001 32ND AVE S STE 420
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98001-9601
Country	:	US
Telephone Number	:	206-870-1345
Fax Number	:	206-870-1321

Provider Business Practice Location Address
First Line	:	826 S 218TH ST
Second Line	:
City	:	DES MOINES
State	:	WA
Zip	:	98198-5180
Country	:	US
Telephone Number	:	206-870-1345
Fax Number	:	206-870-1321

Authorized Official
Title or Position	:	CONTROLLER
Name	:	SYED RASHID
Credential	:
Telephone Number	:	206-870-1310

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	05/11/2026

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