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General NPI Number Information
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NPI Number | 1205983517
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Entity Type | Organization
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Legal Business Name | VASHON ISLAND COMMUNITY CARE
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 15333 VASHON HWY SW
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City | VASHON ISLAND
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State | WA
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Zip | 98070-3831
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Country | US
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Telephone | 206-567-4421
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Fax | 206-567-5052
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Provider Business Mailing Address
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Address Line | 15333 VASHON HWY SW
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City | VASHON ISLAND
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State | WA
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Zip | 98070-3831
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Country | US
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Telephone | 206-567-4421
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Fax | 206-567-5052
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JANELLE ELIZABETH ANSELL
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Credential | NHA00002425
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Telephone | 206-567-4421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1331
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License Number State | WA
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