Organization
WATERMARK BELLEVUE, LLC
Active
Other names
The Springs at Pacific Regent
Organization subpart
No
Provider details
NPI number
Authorized official
GRETA FRAZIER (DIRECTOR)
(520) 797-4000
Entity
Organization
Contact information
Practice address
919 109TH AVE NE, BELLEVUE, WA 98004-4485
(425) 646-9808
(425) 453-8274
Mailing address
2020 W RUDASILL RD, ATTN: MEDICARE BILLING, TUCSON, AZ 85704-7800
(520) 797-4000
(520) 797-7757
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
505371
MEDICARE PTAN
—
Enumeration date
05/11/2015
Last updated
07/15/2015
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