WILDWOOD HEALTHCARE, INC. (NPI# 1407271430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407271430 |
| Entity Type | Organization |
| Organization Name | WILDWOOD HEALTHCARE, INC. |
| Other Organization Name | RAINIER REHABILITATION |
| Practice Address |
920 12th Ave Se Puyallup WA 98372-4920 |
| Practice Telephone | 2538413422 |
| Practice Fax Number | 2538483937 |
| Mailing Telephone | 2538413422 |
| Mailing Fax Number | 2538483937 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |
| Authorized Official Name | SOON BURNAM (TREASURER) |
| Authorized Official Telephone | 9495401249 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | WA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Rainier Rehabilitation | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WILDWOOD HEALTHCARE, INC. | 920 12th Ave Se, Puyallup, WA 98372 |
| Street Address |
920 12TH AVE SE |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-4920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740327279 | Advanced Lifeline Services Inc | Respiratory Therapist, Certified | 920 12th Ave Se, Puyallup, WA 98372 | 2007-02-01 |
| 1790944684 | Nisanth Panicker | Speech-Language Pathologist | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-06-05 |
| 1730348723 | Mylene Foster | Physical Therapist | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-06-04 |
| 1053570259 | Amrita Nambiar | Speech-Language Pathologist | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-06-03 |
| 1306005517 | Dawn Michele Levine | Occupational Therapy Assistant | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-06-03 |
| 1407014566 | Breena Sue Hirsch | Physical Therapy Assistant | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-05-27 |
| 1710144241 | Karin Rae Cummings | Occupational Therapy Assistant | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-05-21 |
| 1366609026 | William Raymond Pyle | Physical Therapy Assistant | 920 12th Ave Se, Puyallup, WA 98372-4920 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790160604 | 400 29th Street Northeast Operations LLC | Skilled Nursing Facility | 400 29th St Ne, Puyallup, WA 98372-6774 | 2015-07-22 |
| 1790182053 | Alaska Gardens | Skilled Nursing Facility | 2549 S Meridian, Puyallup, WA 98373-2753 | 2014-12-01 |
| 1396150215 | Valley Terrace Operations, LLC | Skilled Nursing Facility | 2508 7th St Se, Puyallup, WA 98374-1105 | 2014-06-30 |
| 1902040132 | Summit Pacific Rehabilitation | Skilled Nursing Facility | 909 Meridian St S, Puyallup, WA 98371-6908 | 2009-05-01 |
| 1508811183 | Valley Terrace Operations, LLC | Skilled Nursing Facility | 511 10th Ave Se, Puyallup, WA 98372-3875 | 2006-05-23 |
| 1699760025 | Puyallup Care Center, Inc | Skilled Nursing Facility | 516 23rd Ave Se, Puyallup, WA 98372-4659 | 2005-09-12 |
| 1417959875 | Revera (delaware) LLC | Skilled Nursing Facility | 400 29th Street Ne, Puyallup, WA 98372-6774 | 2005-08-15 |
| 1225414212 | South Hill Operations, LLC | Skilled Nursing Facility | 2508 7th St Se, Puyallup, WA 98374-1105 | 2015-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639717 | Atsugi LLC | Skilled Nursing Facility | 23815 Se 28th St, Sammamish, WA 98075 | 2019-10-02 |
| 1457840795 | Mission Healthcare At Renton, LLC | Skilled Nursing Facility | 17420 106th Pl Se, Renton, WA 98055-5438 | 2018-05-02 |
| 1104330349 | North Auburn Health, LLC | Skilled Nursing Facility | 2830 I Street Ne, Auburn, WA 98002 | 2017-11-27 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1215455365 | Thirty Three Oaks, LLC | Skilled Nursing Facility | 400 E. 33rd St., Vancouver, WA 98663 | 2017-09-08 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1265950422 | University Place Rehabilitation Center, LLC | Skilled Nursing Facility | 5520 Bridgeport Way W., University Place, WA 98467 | 2017-09-07 |
| 1235662081 | Alexandra Vick | Skilled Nursing Facility | 18621 29th Ave E, Tacoma, WA 98445-4323 | 2017-04-08 |
| 1255883831 | Heron's Key | Skilled Nursing Facility | 4340 Borgen Blvd, Gig Harbor, WA 98332-7000 | 2016-10-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.