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General NPI Number Information
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NPI Number | 1144147331
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Entity Type | Organization
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Legal Business Name | SYCAMORE GLEN SL
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 2818 N SULLIVAN RD STE 100-37
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-5198
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Country | US
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Telephone | 509-655-0121
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Fax | 509-463-0893
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Provider Business Mailing Address
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Address Line | PO BOX 272
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City | SPOKANE VALLEY
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State | WA
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Zip | 99037-0272
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Country | US
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Telephone | 509-655-0121
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Fax | 509-463-0893
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHELLE STEVENS
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Credential | RN
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Telephone | 509-332-9152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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