Provider Demographics
NPI:1881023026
Name:ENVISION HOME HEALTH OF WASHINGTON LLC
Entity Type:Organization
Organization Name:ENVISION HOME HEALTH OF WASHINGTON LLC
Other - Org Name:ENVISION HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-7971
Mailing Address - Street 1:1818 S UNION AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1953
Mailing Address - Country:US
Mailing Address - Phone:206-452-0058
Mailing Address - Fax:
Practice Address - Street 1:1818 S UNION AVE STE 1A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:844-500-0720
Practice Address - Fax:844-500-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2056820Medicaid