Healthcare Provider Details

I. General information

NPI: 1730327453
Provider Name (Legal Business Name): HOMEWELL SENIOR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5108 196TH ST SW STE 330
LYNNWOOD WA
98036-6152
US

IV. Provider business mailing address

5108 196TH ST SW STE 330
LYNNWOOD WA
98036-6152
US

V. Phone/Fax

Practice location:
  • Phone: 425-967-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberIHS.FS.00000331
License Number StateWA

VIII. Authorized Official

Name: MR. JOSHUA HOFFMAN
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 425-967-1111