Healthcare Provider Details

I. General information

NPI: 1457793754
Provider Name (Legal Business Name): CATHERINE DAMBROSIO PHD RN &
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 E GRAND AVE
EVERETT WA
98201-3335
US

IV. Provider business mailing address

2026 E GRAND AVE
EVERETT WA
98201-3335
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-3484
  • Fax:
Mailing address:
  • Phone: 206-420-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIHS.FS.60318430
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberIHS.FS.60318430
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1065189
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number1065189
License Number StateWA

VIII. Authorized Official

Name: KARL V DAMBROSIO
Title or Position: CEO
Credential: BS, MS, CDR
Phone: 206-420-3484