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General NPI Number Information
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NPI Number | 1194514752
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Entity Type | Organization
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Legal Business Name | OAK HARBOR RETIREMENT COMMUNITY LLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1040 SW KIMBALL DR
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City | OAK HARBOR
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State | WA
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Zip | 98277-7593
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Country | US
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Telephone | 360-279-0933
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Fax |
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Provider Business Mailing Address
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Address Line | 3326 160TH AVE SE STE 120
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City | BELLEVUE
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State | WA
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Zip | 98008-6418
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Country | US
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Telephone | 425-392-4066
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | M BART BEDDOE
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Credential |
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Telephone | 425-392-4066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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