Healthcare Provider Details

I. General information

NPI: 1356650469
Provider Name (Legal Business Name): THC SEATTLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 07/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10631 8TH AVE NE
SEATTLE WA
98125-7213
US

IV. Provider business mailing address

680 S. 4TH STREET K LIVE 5-REIMBURSEMENT
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 206-364-2050
  • Fax: 206-361-5722
Mailing address:
  • Phone: 502-596-7300
  • Fax: 502-596-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MARILYN A. WEAVER
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 502-596-7563