Provider Demographics
NPI:1396218350
Name:PSL ASSOCIATES LLC, DBA
Entity Type:Organization
Organization Name:PSL ASSOCIATES LLC, DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:BOM
Authorized Official - Phone:360-715-8822
Mailing Address - Street 1:4415 COLUMBINE DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8039
Mailing Address - Country:US
Mailing Address - Phone:360-715-8822
Mailing Address - Fax:360-715-8818
Practice Address - Street 1:4415 COLUMBINE DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8039
Practice Address - Country:US
Practice Address - Phone:360-715-8822
Practice Address - Fax:360-715-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1841627890Medicaid