Provider Demographics
NPI:1366865644
Name:LILIA L. ORTEGA RND
Entity Type:Organization
Organization Name:LILIA L. ORTEGA RND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, BSN
Authorized Official - Prefix:
Authorized Official - First Name:LILIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:IX
Authorized Official - Credentials:
Authorized Official - Phone:360-521-3776
Mailing Address - Street 1:3703 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-1965
Mailing Address - Country:US
Mailing Address - Phone:360-521-3776
Mailing Address - Fax:360-750-0133
Practice Address - Street 1:3703 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-1965
Practice Address - Country:US
Practice Address - Phone:360-521-3776
Practice Address - Fax:360-750-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00095259311ZA0620X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home