Provider Demographics
NPI:1770323933
Name:EASTSIDE HEALTHCARE STAFFING LLC
Entity type:Organization
Organization Name:EASTSIDE HEALTHCARE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMWASE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-309-1837
Mailing Address - Street 1:19331 63RD PL NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3370
Mailing Address - Country:US
Mailing Address - Phone:252-309-1837
Mailing Address - Fax:
Practice Address - Street 1:19331 63RD PL NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3370
Practice Address - Country:US
Practice Address - Phone:252-309-1837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health