Provider Demographics
NPI:1760439467
Name:LYNNWOOD HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:LYNNWOOD HEALTH SERVICES, INC.
Other - Org Name:LYNNWOOD POST ACUTE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:5821 188TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4304
Mailing Address - Country:US
Mailing Address - Phone:425-776-5512
Mailing Address - Fax:425-776-3230
Practice Address - Street 1:5821 188TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4304
Practice Address - Country:US
Practice Address - Phone:425-776-5512
Practice Address - Fax:425-776-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4113957Medicaid
WA50-5434Medicare ID - Type Unspecified