MEDICARE: THE KENNEY

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
2	314000000X	Skilled Nursing Facility	241	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	:	1619934999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE KENNEY

Provider Business Mailing Address
First Line	:	7125 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-2008
Country	:	US
Telephone Number	:	206-937-2800
Fax Number	:	209-938-6940

Provider Business Practice Location Address
First Line	:	7125 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-2008
Country	:	US
Telephone Number	:	206-937-2800
Fax Number	:	206-938-6940

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. LARRY FOSS
Credential	:
Telephone Number	:	206-933-2783

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	05/20/2015

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Directions to “THE KENNEY ” Practice Location

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