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General NPI Number Information
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NPI Number | 1457793754
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Entity Type | Organization
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Legal Business Name | CATHERINE DAMBROSIO PHD RN &
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Dates
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Enumeration Date | 07/27/2013
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 2026 E GRAND AVE
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City | EVERETT
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State | WA
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Zip | 98201-3335
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Country | US
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Telephone | 206-420-3484
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 E GRAND AVE
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City | EVERETT
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State | WA
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Zip | 98201-3335
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Country | US
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Telephone | 206-420-3484
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KARL V DAMBROSIO
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Credential | BS, MS, CDR
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Telephone | 206-420-3484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHS.FS.60318430
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | IHS.FS.60318430
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 1065189
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 1065189
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License Number State | WA
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