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Crestwood Convalescent - Port Angeles LLC

Skilled Nursing Facility in Port Angeles, WA · enumerated 2006 · authorized official Dov Jacobs, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1417029885

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Registry record

Entity type Organization (Type 2)
Legal business name Crestwood Convalescent - Port Angeles LLC
Other name <Unavail>
Practice address 1116 E Lauridsen Blvd, Port Angeles, WA, 98362
Phone (360) 452-9206
Fax (360) 457-2935
Enumeration date Nov 14, 2006
Last updated in NPPES Aug 18, 2017

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities Primary

Authorized official

Name Dov Jacobs
Title Manager
Phone (323) 678-4426

Other identifiers

Identifier Type State Issuer
4111688 Medicaid WA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Crestwood Convalescent - Port Angeles LLC?
NPPES lists Dov Jacobs (Manager) as the authorized official for this organization.
What is the NPI number for Crestwood Convalescent - Port Angeles LLC?
The NPI for Crestwood Convalescent - Port Angeles LLC is 1417029885, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2017-08-18.