Healthcare Provider Details

I. General information

NPI: 1962978809
Provider Name (Legal Business Name): GERICEF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 156TH PL SE
BOTHELL WA
98012-4742
US

IV. Provider business mailing address

3506 156TH PL SE
BOTHELL WA
98012-4742
US

V. Phone/Fax

Practice location:
  • Phone: 206-434-2632
  • Fax:
Mailing address:
  • Phone: 206-434-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: BAKARY DARBOE
Title or Position: CO-OWNER
Credential: NURSE
Phone: 206-434-2632