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General NPI Number Information
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NPI Number | 1801765110
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Entity Type | Organization
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Legal Business Name | CHERISHED SENIORS AT BONNEY LAKE LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 8105 210TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-8432
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Country | US
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Telephone | 253-394-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 S 334TH ST
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City | FEDERAL WAY
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State | WA
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Zip | 98001-9628
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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 | GOVERNING MEMBER
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Name | MUHAMMAD SAAD MOHYUDDIN
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Credential |
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Telephone | 253-394-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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