EVERGREEN MANOR HEALTH AND REHABILITATION CENTER
NPI 1619925328
Skilled Nursing Facility in Longview, WA

Active since May 05, 2006
1330 11TH AVE, LONGVIEW, WA 98632(360) 425-6706(360) 423-3002 Get Directions Write a Review

NPPES record last updated: July 7, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Manor Health And Rehabilitation Center NPPES

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

EVERGREEN MANOR HEALTH AND REHABILITATION CENTER (NPI 1619925328) is a healthcare organization registered as a skilled nursing facility in Longview, Washington and active in the NPI registry since May 2006. The organization lists Dale L. Patterson, Manager, as its authorized official.

NPPES Registry Identity

NPI1619925328
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEVERGREEN WASHINGTON HEALTHCARE MANOR, L.L.C.
Location Address1330 11TH AVELongview, WA 98632-3817
Mailing Address4601 Ne 77th Ave, Suite 300Vancouver, WA 98662-6729 · (360) 892-6628 · Fax (360) 882-5793
Fax(360) 423-3002
Organization SubpartNo
Authorized OfficialDale L. PattersonManager · (360) 892-6628
Enumeration DateMay 5, 2006
Last NPPES UpdateJuly 7, 2008
NPI 1619925328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in WA · 1226
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1330 11TH AVE, Longview, WA 98632

Other Names 1

Doing Business AsEvergreen Manor Health And Rehabilitation Center

Other Identifiers 2

Medicaid4112264WA
Medicare ID-Type Unspecified505253WA

Other Providers at the Same Location NPPES

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

Registered Nurse
1330 11TH AVE
LONGVIEW, WA 98632

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 Evergreen Washington Healthcare Manor, L.L.C.'s NPI number?

The NPI number for Evergreen Washington Healthcare Manor, L.L.C. is 1619925328. It was assigned to this organization in the NPPES registry on May 5, 2006. The provider is doing business as Evergreen Manor Health And Rehabilitation Center.

Where is Evergreen Washington Healthcare Manor, L.L.C. located?

Evergreen Washington Healthcare Manor, L.L.C. is located at 1330 11th Ave, Longview, WA 98632. The listed phone number is (360) 425-6706.

What is Evergreen Washington Healthcare Manor, L.L.C.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Evergreen Washington Healthcare Manor, L.L.C. was last updated on July 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.