Healthcare Provider Details

I. General information

NPI: 1689805368
Provider Name (Legal Business Name): SEATTLE CHINATOWN INTERNATIONAL DISTRICT PRESERVATION & DEVELOPMENT AU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 S LANE ST
SEATTLE WA
98104-3044
US

IV. Provider business mailing address

803 S LANE ST
SEATTLE WA
98104-3044
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-5184
  • Fax: 206-838-3057
Mailing address:
  • Phone: 206-292-5184
  • Fax: 206-838-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberBH1203
License Number StateWA

VIII. Authorized Official

Name: MS. VERONICA WOOD
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 206-838-8231