Provider Demographics
NPI:1306934146
Name:RAINSHADOW HOME SERVICES, INC.
Entity type:Organization
Organization Name:RAINSHADOW HOME SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-681-6206
Mailing Address - Street 1:1001 E WASHINGTON ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3575
Mailing Address - Country:US
Mailing Address - Phone:360-681-6206
Mailing Address - Fax:360-681-6208
Practice Address - Street 1:1001 E WASHINGTON ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3575
Practice Address - Country:US
Practice Address - Phone:360-681-6206
Practice Address - Fax:360-681-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-428251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA962384Medicaid
WA1099OtherBLUE CROSS ID#
WA9050618Medicaid