# BD TACOMA I, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PARK ROSE CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316045537
- **Authorized official:** DOUG DEVORE (FIELD ACCOUNTANT)
- **Authorized official phone:** (425) 392-4066

## Contact information

- **Practice address:** 3919 S 19TH ST, TACOMA, WA 98405-1414
- **Practice address phone:** (253) 752-5677
- **Practice address fax:** (253) 756-8936
- **Mailing address:** 3326 160TH AVE SE, SUITE 120, BELLEVUE, WA 98008-6418
- **Mailing address phone:** (425) 392-4066
- **Mailing address fax:** (425) 623-1517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH1298 | WA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 05/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4112983 | — | WA |
| 05 | — | 4114245 | — | WA |