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NPI 1619565165

NPI 1619565165 : THE DOCTOR'S INN: PLEASANT VIEW INCORPORATED : VANCOUVER, WA

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General NPI Number Information
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    NPI Number           |    1619565165
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    Entity Type          |    Organization 
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    Legal Business Name  |    THE DOCTOR'S INN: PLEASANT VIEW INCORPORATED 
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Dates
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    Enumeration Date     |    01/08/2021
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    Last Update Date     |    01/08/2021
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Provider Practice Location Address
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    Address Line         |    609 NW OVERLOOK DR 
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    City                 |    VANCOUVER
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    State                |    WA
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    Zip                  |    98665-7441
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    Country              |    US
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    Telephone            |    360-433-2017
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    609 NW OVERLOOK DR 
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    City                 |    VANCOUVER
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    State                |    WA
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    Zip                  |    98665-7441
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    Country              |    US
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    Telephone            |    360-433-2017
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DANIEL  ROA 
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    Credential           |    
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    Telephone            |    541-720-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    311ZA0620X
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    Taxonomy Name        |    Adult Care Home Facility
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    License Number       |    
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    License Number State |    
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