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General NPI Number Information
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NPI Number | 1174097224
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Entity Type | Organization
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Legal Business Name | BFG OLYMPIA PROPCO III, LLC
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 710 FIELDSTONE DR SW
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City | OLYMPIA
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State | WA
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Zip | 98502-5500
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Country | US
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Telephone | 360-250-9229
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Fax |
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Provider Business Mailing Address
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Address Line | 506 N 40TH AVE STE 100
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City | YAKIMA
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State | WA
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Zip | 98908-4330
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Country | US
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Telephone | 509-426-2756
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Fax |
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Authorized Official
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Title or Position | MANAGER DIRECTOR OF COMPLIANCE
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Name | FAYE GORDON
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Credential | DO
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Telephone | 509-426-2756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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