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General NPI Number Information
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NPI Number | 1093813214
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Entity Type | Organization
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Legal Business Name | BD OLYMPIA I, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 1811 22ND AVE SE
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City | OLYMPIA
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State | WA
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Zip | 98501-3023
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Country | US
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Telephone | 360-943-0910
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Fax | 360-753-8259
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Provider Business Mailing Address
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Address Line | 3326 160TH AVE SE SUITE 120
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City | BELLEVUE
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State | WA
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Zip | 98008-6418
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Country | US
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Telephone | 425-392-4066
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Fax | 425-623-1517
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Authorized Official
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Title or Position | CFO
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Name | DOUG DEVORE
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Credential |
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Telephone | 425-392-4066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH1179
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License Number State | WA
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