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General NPI Number Information
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NPI Number | 1316932114
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Entity Type | Organization
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Legal Business Name | RICHMOND BEACH REHAB LLC
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Dates
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Enumeration Date | 09/18/2005
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 19235 15TH AVE NW
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City | SHORELINE
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State | WA
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Zip | 98177-2725
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Country | US
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Telephone | 206-546-2666
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Fax | 206-542-1164
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Provider Business Mailing Address
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Address Line | 19235 15TH AVE NW
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City | SHORELINE
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State | WA
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Zip | 98177-2725
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Country | US
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Telephone | 206-546-2666
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Fax | 206-542-1164
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Authorized Official
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Title or Position | CEO
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Name | MARY E. KOFSTAD
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Credential |
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Telephone | 971-224-2033
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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 |
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License Number State | WA
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