# MISSION HEALTHCARE AT RENTON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mission Healthcare at Renton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457840795
- **Authorized official:** DR. KENNETH FARMER MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (253) 853-4457

## Contact information

- **Practice address:** 17420 106TH PL SE, RENTON, WA 98055-5438
- **Practice address phone:** (425) 897-8800
- **Practice address fax:** (425) 897-8801
- **Mailing address:** 17420 106TH PL SE, RENTON, WA 98055-5438
- **Mailing address phone:** (425) 897-8800
- **Mailing address fax:** (425) 897-8801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/02/2018
- **Last updated:** 05/02/2018