Provider Demographics
NPI:1215441407
Name:PUGET SOUND HEALTHCARE-OLYMPIA, LLC
Entity type:Organization
Organization Name:PUGET SOUND HEALTHCARE-OLYMPIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLMARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-251-9081
Mailing Address - Street 1:3220 ROSEDALE ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-858-7273
Mailing Address - Fax:
Practice Address - Street 1:4001 CAPITAL MALL DR SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-754-9792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility