Provider Demographics
NPI:1326030834
Name:CASHMERE CONVALESCENT CENTER INC.
Entity Type:Organization
Organization Name:CASHMERE CONVALESCENT CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRONEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-782-1251
Mailing Address - Street 1:817 PIONEER AVE
Mailing Address - Street 2:P.O. BOX 626
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-1235
Mailing Address - Country:US
Mailing Address - Phone:509-782-1251
Mailing Address - Fax:509-782-4221
Practice Address - Street 1:817 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1235
Practice Address - Country:US
Practice Address - Phone:509-782-1251
Practice Address - Fax:509-782-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANH 677314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4167706Medicaid
WA50-5151Medicare ID - Type Unspecified