MEDICARE: WAATU INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	4113718	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508877895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAATU INC.

Provider Business Mailing Address
First Line	:	911 21ST ST
Second Line	:
City	:	ANACORTES
State	:	WA
Zip	:	98221-2513
Country	:	US
Telephone Number	:	360-293-7222
Fax Number	:	360-293-7281

Provider Business Practice Location Address
First Line	:	1105 27TH ST
Second Line	:
City	:	ANACORTES
State	:	WA
Zip	:	98221-2710
Country	:	US
Telephone Number	:	360-293-3174
Fax Number	:	360-293-4418

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES K ROE
Credential	:
Telephone Number	:	360-293-7222

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	11/07/2014

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Directions to “WAATU INC. ” Practice Location

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