MEDICARE: KIN ON HEALTH CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	1221	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366441834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIN ON HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	4416 S BRANDON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2341
Country	:	US
Telephone Number	:	206-721-3630
Fax Number	:	206-721-3626

Provider Business Practice Location Address
First Line	:	4416 S BRANDON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2341
Country	:	US
Telephone Number	:	206-721-3630
Fax Number	:	206-721-3626

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	KETTY HSIEH
Credential	:
Telephone Number	:	206-556-2222

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	06/03/2022

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