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General NPI Number Information
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NPI Number | 1568429900
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Entity Type | Organization
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Legal Business Name | BROADVIEW DEVELOPMENT ASSOCIATES II
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 12505 GREENWOOD AVE N
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City | SEATTLE
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State | WA
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Zip | 98133
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Country | US
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Telephone | 206-368-3797
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Fax | 206-368-3756
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Provider Business Mailing Address
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Address Line | 12505 GREENWOOD AVE N
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City | SEATTLE
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State | WA
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Zip | 98133
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Country | US
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Telephone | 206-368-3797
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Fax | 206-368-3756
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES ADMIN
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Name | TARA L TRAVERS
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Credential | NHA
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Telephone | 206-368-3797
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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 | 945
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1065
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License Number State | WA
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