NPI 1073745113

Wilderness Shores Nursing, LLC

Organisation Home Health Agency Maple Valley, WA

Practice location

Address: 25614 Lake Wilderness Ln SE, Maple Valley, WA 98038-6019
Phone: (206) 931-5284
Fax: (425) 413-5116

Authorised official

Name: Shirley Ann McMonagle
Title: Administrator
Phone: (206) 931-5284

Registered specialties

Home Health Agency Primary

Agencies Taxonomy 251E00000X Licence IHS.FS.60055610 (WA)

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Registry record

NPI: 1073745113
Entity type: Organization
NPI issued: 21 Aug 2009
Record last updated: 21 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.