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General NPI Number Information
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NPI Number | 1740729987
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Entity Type | Organization
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Legal Business Name | WAATU, INC.
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 911 21ST ST
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City | ANACORTES
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State | WA
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Zip | 98221-2513
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Country | US
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Telephone | 360-293-7222
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Fax | 360-293-7281
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Provider Business Mailing Address
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Address Line | 1105 27TH ST
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City | ANACORTES
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State | WA
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Zip | 98221-2710
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Country | US
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Telephone | 360-293-3174
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Fax | 360-293-4418
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Authorized Official
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Title or Position | VP CFO
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Name | DAVID KIEFER
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Credential |
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Telephone | 360-293-3174
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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 | 1313
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License Number State | WA
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