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General NPI Number Information
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NPI Number | 1336147388
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Entity Type | Organization
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Legal Business Name | CASCADE VISTA CONVALESCENT CENTER, INC.
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 7950 WILLOWS RD NE
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City | REDMOND
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State | WA
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Zip | 98052-6813
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Country | US
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Telephone | 425-885-4157
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Fax | 425-882-3308
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Provider Business Mailing Address
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Address Line | 7950 WILLOWS RD NE
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City | REDMOND
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State | WA
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Zip | 98052-6813
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Country | US
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Telephone | 425-885-4157
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Fax | 425-882-3308
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Authorized Official
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Title or Position | CONTROLLER
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Name | TERRY CAFFEY
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Credential |
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Telephone | 425-885-4157
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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 | NH954
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License Number State | WA
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