Healthcare Provider Details

I. General information

NPI: 1720028509
Provider Name (Legal Business Name): TOUCHMARK ON SOUTH HILL LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 S WATERFORD DR
SPOKANE WA
99203-4400
US

IV. Provider business mailing address

5150 SW GRIFFITH DR
BEAVERTON OR
97005-2935
US

V. Phone/Fax

Practice location:
  • Phone: 509-536-2929
  • Fax: 503-536-3999
Mailing address:
  • Phone: 503-646-5186
  • Fax: 503-644-3568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH1201
License Number StateWA

VIII. Authorized Official

Name: MR. BRIAN E PRYOR
Title or Position: EVP OPERATIONS
Credential:
Phone: 503-646-5186