Healthcare Provider Details

I. General information

NPI: 1902870686
Provider Name (Legal Business Name): GEORGIAN REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8407 STEILACOOM BLVD SW
LAKEWOOD WA
98498-4706
US

IV. Provider business mailing address

8407 STEILACOOM BOULEVARD, SOUTHWEST
AUBURN WA
98498
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-2146
  • Fax: 253-582-3607
Mailing address:
  • Phone: 253-588-2146
  • Fax: 253-582-3607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ALLYSON JENKINS
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 253-588-2146