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General NPI Number Information
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NPI Number | 1881796258
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Entity Type | Organization
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Legal Business Name | REGENCY AUBURN, LLC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 414 17TH ST SE
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City | AUBURN
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State | WA
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Zip | 98002-6822
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Country | US
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Telephone | 253-833-1740
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Fax | 253-833-2050
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Provider Business Mailing Address
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Address Line | 414 17TH ST SE
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City | AUBURN
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State | WA
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Zip | 98002-6822
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Country | US
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Telephone | 253-833-1740
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Fax | 253-833-2050
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | M. BART BEDDOE
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Credential |
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Telephone | 425-392-4066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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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 | 1195
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License Number State | WA
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