OrganizationActive
Evergreen Washington Healthcare Frontier, L.L.C.
NPI 1104811207 · Skilled Nursing Facility · Longview, WA
Provider details
- NPI number
- 1104811207
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Parent organization
- Empres Washington Healthcare, LLC
- Organization subpart
- Yes
- Authorized official
- Brent Weil, Ceo and Manager(360) 892-6628
- License
- 1225 (WA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1500 3rd Ave
Longview, WA 98632-8632
Phone: (360) 423-8800
Fax: (360) 636-3421
Street-level locationGet directions
Mailing address
4601 Ne 77th Ave
Vancouver, WA 98662-6736
Other names (DBA / former)
- Doing business as
- Frontier Rehabilitation and Extended Care Center
Registry dates
- Enumerated
- 2005-09-14
- Last updated
- 2017-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.