1. Home
  2. Directory
  3. Washington
  4. Walla Walla
  5. Assisted Living Facility
  6. NPI Profile

WASHINGTON ODD FELLOWS HOME
NPI 1114917630
Assisted Living Facility in Walla Walla, WA

Active since October 26, 2005CLIA 50D0661629 · Waiver
1/5
Overall Rating
534 BOYER AVE, WALLA WALLA, WA 99362(509) 525-6463(509) 522-0578 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Washington Odd Fellows Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WASHINGTON ODD FELLOWS HOME (NPI 1114917630) is a healthcare organization registered as an assisted living facility in Walla Walla, Washington and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists John R Brigham, Administrator, as its authorized official.

NPPES Registry Identity

NPI1114917630
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWASHINGTON ODD FELLOWS HOME
Location Address534 BOYER AVEWalla Walla, WA 99362-2047
Mailing Address534 Boyer AveWalla Walla, WA 99362-2047 · (509) 525-6463 · Fax (509) 522-0578
Phone(509) 525-6463
Fax(509) 522-0578
Organization SubpartNo
Authorized OfficialJohn R BrighamAdministrator · (509) 525-6463
Enumeration DateOctober 26, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1114917630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in WA · BH125
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
534 BOYER AVE, Walla Walla, WA 99362
Open in Google Maps ↗

Other Identifiers 1

Medicaid129082WA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0661629

Washington Odd Fellows Home · Walla Walla, WA
Active · expires Apr 4, 2028
CLIA Number50D0661629
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 1992
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJeanette Bartholomew
Laboratory Phone(509) 525-6463
Laboratory LocationWashington Odd Fellows Home534 Boyer Avenue, Walla Walla, WA 99362
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Washington Odd Fellows Home (CMS certification number 505421), from CMS Care Compare.

Washington Odd Fellows Home

Nursing home · Walla Walla, WA
1/5 CMS Overall Rating
OwnershipNon profit - Corporation
CMS Certification Number505421
Certified Beds117 beds57 residents per day on average
Medicare & Medicaid Participant SinceJanuary 1, 1992
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
201.5
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.39 · LPN 0.83 · RN 0.95
4.17 hrs per resident per day
Weekend Nurse Staffing
3.34 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
19
Substantiated Complaints
13
Infection-Control Citations
8
Fines
4 totaling $151,709.35
Medicare Payment Denials
0
Total Penalties
4
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EILEEN BLUTE
Speech-Language Pathologist
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (509) 525-6463
MS. MARIA CAROLINA SBODIO PT, DPT
Physical Therapist
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (509) 526-6809
GLORIA LUCIA MORENO
Occupational Therapy Assistant
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (509) 525-6463
LINDSAY ANNE DRANGO
Prevention Professional
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (503) 804-3345
WILLIAM KEITH KEYSER
Occupational Therapy Assistant
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (509) 525-6463
MARIE KYLEE MANON SETO-HERR DPT
Physical Therapist
534 BOYER AVE
WALLA WALLA, WA 99362
Walla Walla County (509) 525-6463

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Washington Odd Fellows Home's NPI number?

The NPI number for Washington Odd Fellows Home is 1114917630. It was assigned to this organization in the NPPES registry on October 26, 2005.

Where is Washington Odd Fellows Home located?

Washington Odd Fellows Home is located at 534 Boyer Ave, Walla Walla, WA 99362. The listed phone number is (509) 525-6463.

What is Washington Odd Fellows Home's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Washington Odd Fellows Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0661629) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Washington Odd Fellows Home a Medicare-certified nursing home?

Yes. Washington Odd Fellows Home is a Medicare-certified nursing home with 117 certified beds.

What quality rating does Washington Odd Fellows Home have?

CMS rates Washington Odd Fellows Home 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Washington Odd Fellows Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.