MEDICARE: MILLENNIA HEALTHCARE, 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
1	251E00000X	Home Health Agency	IS-377	WA

General Provider Information

NPI Number	:	1790996536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIA HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	21400 INTERNATIONAL BLVD SUITE 303
Second Line	:
City	:	SEATAC
State	:	WA
Zip	:	98198
Country	:	US
Telephone Number	:	206-878-0909
Fax Number	:	206-878-5259

Provider Business Practice Location Address
First Line	:	21400 INTERNATIONAL BLVD
Second Line	:	SUITE 205
City	:	SEATAC
State	:	WA
Zip	:	98198-6086
Country	:	US
Telephone Number	:	206-878-0909
Fax Number	:	206-878-5259

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LAWRENCE OBIECHINA UDE
Credential	:
Telephone Number	:	206-878-0909

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/23/2025

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