Healthcare Provider Details

I. General information

NPI: 1871947317
Provider Name (Legal Business Name): EMERALD CITY TRANSITIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5611 S BANGOR ST
SEATTLE WA
98178-2237
US

IV. Provider business mailing address

5611 S BANGOR ST
SEATTLE WA
98178-2237
US

V. Phone/Fax

Practice location:
  • Phone: 206-353-5729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number603424634
License Number StateWA

VIII. Authorized Official

Name: REBECCA HUDSON
Title or Position: EXECUTIVE TRANSITION SPECIALIST
Credential:
Phone: 206-353-5729