MEDICARE: GENTEEL INC

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1841846409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTEEL INC

Provider Business Mailing Address
First Line	:	781 KAYNOR RD
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-8691
Country	:	US
Telephone Number	:	509-929-4207
Fax Number	:	509-349-5055

Provider Business Practice Location Address
First Line	:	781 KAYNOR RD
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-8691
Country	:	US
Telephone Number	:	509-929-4207
Fax Number	:	509-349-5055

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EUGENE NASSEN
Credential	:
Telephone Number	:	509-929-4207

Provider Enumeration Date	:	08/09/2019
Last Update Date	:	08/09/2019

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Directions to “GENTEEL INC ” Practice Location

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