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General NPI Number Information
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NPI Number | 1932157641
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Entity Type | Organization
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Legal Business Name | EVERGREEN WASHINGTON HEALTHCARE GREENWOOD, L.L.C.
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2424 156TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98007-3814
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Country | US
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Telephone | 425-897-8800
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Fax | 425-897-8801
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Provider Business Mailing Address
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Address Line | 4601 NE 77TH AVE STE 300
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City | VANCOUVER
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State | WA
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Zip | 98662-6736
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Country | US
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Telephone | 360-892-6628
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Fax | 360-882-5793
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Authorized Official
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Title or Position | CEO AND MANAGER
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Name | BRENT WEIL
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Credential |
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Telephone | 360-892-6628
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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 | 1309
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License Number State | WA
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