Healthcare Provider Details

I. General information

NPI: 1790953099
Provider Name (Legal Business Name): DEPARTMENT OF VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

4811 S GRAHAM ST #D
SEATTLE WA
98118
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-1010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLP00059774
License Number StateWA

VIII. Authorized Official

Name: MS. DIEU MINH THI HOANG
Title or Position: LICENSED PRACTICAL NURSE
Credential:
Phone: 206-725-5098