Healthcare Provider Details

I. General information

NPI: 1326032962
Provider Name (Legal Business Name): CAROLINE KLINE GALLAND HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SEWARD PARK AVE S
SEATTLE WA
98118-4247
US

IV. Provider business mailing address

7500 SEWARD PARK AVE S
SEATTLE WA
98118-4247
US

V. Phone/Fax

Practice location:
  • Phone: 206-725-8800
  • Fax: 206-722-5210
Mailing address:
  • Phone: 206-725-8800
  • Fax: 206-722-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number658
License Number StateWA

VIII. Authorized Official

Name: JEFFREY DAVID COHEN
Title or Position: CEO
Credential:
Phone: 206-725-8800