1548513252 NPI number — CAROLINE KLINE GALLAND HOME

Table of content: (NPI 1548513252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548513252 NPI number — CAROLINE KLINE GALLAND HOME

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINE KLINE GALLAND HOME
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KLINE GALLAND HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548513252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 SEWARD PARK AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98118-4247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-725-8800
Provider Business Mailing Address Fax Number:
206-722-5210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5950 6TH AVE S
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108-3317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-805-1930
Provider Business Practice Location Address Fax Number:
206-805-1931
Provider Enumeration Date:
10/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
AN
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR & COO
Authorized Official Telephone Number:
206-725-8800

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  IHS.FS.60103742 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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