Provider Demographics
NPI:1124011499
Name:PANORAMA
Entity Type:Organization
Organization Name:PANORAMA
Other - Org Name:PANORAMA CONAVALESCENT & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:NH00002387
Authorized Official - Phone:360-438-7718
Mailing Address - Street 1:1600 SLEATER KINNEY RD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2500
Mailing Address - Country:US
Mailing Address - Phone:360-438-5000
Mailing Address - Fax:360-413-6015
Practice Address - Street 1:1600 SLEATER KINNEY RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2500
Practice Address - Country:US
Practice Address - Phone:360-438-5000
Practice Address - Fax:360-413-6015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50-5059310400000X
WA41-507-02313M00000X
WANH507314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4150702Medicaid
WA4150702Medicaid