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General NPI Number Information
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NPI Number | 1790953099
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERANS AFFAIRS
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 206-762-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 4811 S GRAHAM ST #D
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City | SEATTLE
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State | WA
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Zip | 98118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MS. DIEU MINH THI HOANG
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Credential |
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Telephone | 206-725-5098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | LP00059774
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License Number State | WA
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