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General NPI Number Information
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NPI Number | 1700567419
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Entity Type | Organization
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Legal Business Name | SHINING HOME HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2707 S 260TH LN APT J206
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City | KENT
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State | WA
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Zip | 98032-8952
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Country | US
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Telephone | 206-778-1082
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Fax | 206-687-9723
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Provider Business Mailing Address
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Address Line | 2707 S 260TH LN APT J206
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City | KENT
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State | WA
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Zip | 98032-8952
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Country | US
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Telephone | 206-778-1082
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Fax | 206-687-9723
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Authorized Official
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Title or Position | OWNER
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Name | ELAINE MATTHEWS
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Credential | RN
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Telephone | 253-224-7660
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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 |
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License Number State |
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