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NPI Code Detail

MEDICARE: LUTHERAN RETIREMENT HOME OF GREATER SEATTLE INC

MEDICARE: LUTHERAN RETIREMENT HOME OF GREATER SEATTLE INC
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
1314000000XSkilled Nursing Facility505027WA

Other Identifiers

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

General Provider Information

NPI Number : 1417038605
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN RETIREMENT HOME OF GREATER SEATTLE INC
Provider Business Mailing Address
First Line : 6720 E GREEN LAKE WAY N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-5439
Country : US
Telephone Number : 206-517-2225
Fax Number : 206-517-2275
Provider Business Practice Location Address
First Line : 6720 E GREEN LAKE WAY N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-5439
Country : US
Telephone Number : 206-517-2225
Fax Number : 206-517-2275
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MR. R KEVIN MCFEELY
Credential :
Telephone Number : 206-517-2225
Provider Enumeration Date : 10/17/2006
Last Update Date : 05/27/2014

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