Healthcare Provider Details

I. General information

NPI: 1033106646
Provider Name (Legal Business Name): SEATTLE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 E JEFFERSON ST
SEATTLE WA
98122-5336
US

IV. Provider business mailing address

1020 E JEFFERSON ST
SEATTLE WA
98122-5336
US

V. Phone/Fax

Practice location:
  • Phone: 206-323-1028
  • Fax: 206-323-8861
Mailing address:
  • Phone: 206-323-1028
  • Fax: 206-323-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH 1057
License Number StateWA

VIII. Authorized Official

Name: SUSAN R STEINER
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 206-323-1028