Provider Demographics
NPI:1578907275
Name:PANORAMA ASSISTED LIVING
Entity Type:Organization
Organization Name:PANORAMA ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-438-7880
Mailing Address - Street 1:1835 CIRCLE LN SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2572
Mailing Address - Country:US
Mailing Address - Phone:360-438-7880
Mailing Address - Fax:360-413-6002
Practice Address - Street 1:1835 CIRCLE LN SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2572
Practice Address - Country:US
Practice Address - Phone:360-438-7880
Practice Address - Fax:360-413-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAB1161310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility