Healthcare Provider Details

I. General information

NPI: 1366441834
Provider Name (Legal Business Name): KIN ON HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 S BRANDON ST
SEATTLE WA
98118-2341
US

IV. Provider business mailing address

4416 S BRANDON ST
SEATTLE WA
98118-2341
US

V. Phone/Fax

Practice location:
  • Phone: 206-721-3630
  • Fax: 206-721-3626
Mailing address:
  • Phone: 206-721-3630
  • Fax: 206-721-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1221
License Number StateWA

VIII. Authorized Official

Name: KETTY HSIEH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 206-556-2222