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General NPI Number Information
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NPI Number | 1649411190
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Entity Type | Organization
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Legal Business Name | PREMIER NURSING CARE AGENCY
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | 5707 SOUTH AUGUSTA ST
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City | SEATTLE
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State | WA
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Zip | 98178
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Country | US
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Telephone | 206-722-5100
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Fax | 206-722-0394
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Provider Business Mailing Address
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Address Line | 5707 SOUTH AUGUSTA ST
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City | SEATTLE
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State | WA
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Zip | 98178
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Country | US
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Telephone | 206-722-5100
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Fax | 206-722-0394
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FORSON ADDAE BOATENG
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Credential | RN
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Telephone | 206-722-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00162766
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License Number State | WA
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