Healthcare Provider Details

I. General information

NPI: 1245157825
Provider Name (Legal Business Name): ROWAN RIDGE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 FRONT ST S
ISSAQUAH WA
98027-4205
US

IV. Provider business mailing address

805 FRONT ST S
ISSAQUAH WA
98027-4205
US

V. Phone/Fax

Practice location:
  • Phone: 425-392-1271
  • Fax: 425-557-5563
Mailing address:
  • Phone: 425-392-1271
  • Fax: 425-557-5563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: SECRETARY
Credential:
Phone: 949-540-1249