Healthcare Provider Details

I. General information

NPI: 1609021815
Provider Name (Legal Business Name): NORTHWEST HOMECARE & STAFFING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11222 ROOSEVELT WAY NE
SEATTLE WA
98125-6241
US

IV. Provider business mailing address

11222 ROOSEVELT WAY NE
SEATTLE WA
98125-6241
US

V. Phone/Fax

Practice location:
  • Phone: 206-774-1100
  • Fax: 206-361-2339
Mailing address:
  • Phone: 206-774-1100
  • Fax: 206-361-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIHS.FS.00000096
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberIHS.FS.00000096
License Number StateWA

VIII. Authorized Official

Name: BENNETT SOLOMON
Title or Position: OWNER
Credential:
Phone: 206-774-1100