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General NPI Number Information
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NPI Number | 1407858681
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Entity Type | Organization
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Legal Business Name | BESSIE BURTON SULLIVAN HOME HEALTH AGENCY
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 2424 156TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98007-3814
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Country | US
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Telephone | 425-519-1265
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Fax | 425-641-1115
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Provider Business Mailing Address
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Address Line | 1020 E JEFFERSON ST
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City | SEATTLE
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State | WA
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Zip | 98122-5336
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Country | US
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Telephone | 206-328-7850
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Fax | 206-568-8575
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DOROTHY R GRAINGER
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Credential | RN, MSN, MBA
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Telephone | 206-328-7850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IS- 234
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License Number State | WA
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