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General NPI Number Information
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NPI Number | 1215277538
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Entity Type | Organization
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Legal Business Name | MOSS BAY SENIOR LIVING, INC.
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Dates
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Enumeration Date | 02/22/2013
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 7950 WILLOWS RD NE
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City | REDMOND
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State | WA
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Zip | 98052-6813
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Country | US
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Telephone | 425-885-4157
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Fax | 425-882-3308
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Provider Business Mailing Address
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Address Line | 7950 WILLOWS RD NE
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City | REDMOND
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State | WA
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Zip | 98052-6813
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Country | US
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Telephone | 425-885-4157
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Fax | 425-882-3308
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Authorized Official
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Title or Position | TREASURER
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Name | LEE JOHNSON
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Credential |
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Telephone | 208-401-1369
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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 | WA
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