Healthcare Provider Details

I. General information

NPI: 1497392708
Provider Name (Legal Business Name): SEATTLE GERIATRIC HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 PHINNEY AVE N
SEATTLE WA
98103-6374
US

IV. Provider business mailing address

6825 40TH AVE NE
SEATTLE WA
98115-7531
US

V. Phone/Fax

Practice location:
  • Phone: 206-632-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ANN MARIE MOSBACHER
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 206-539-9474