Organization
BLUERIDGE AFH LLC
Active
Organization
BLUERIDGE AFH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMANTE FERNANDO TADIQUE (CEO)
(206) 755-0861
Entity
Organization
Contact information
Practice address
2106 NW 97TH ST, SEATTLE, WA 98117-2451
(206) 755-0861
Mailing address
2106 NW 97TH ST, SEATTLE, WA 98117-2451
(206) 755-0861
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
A750023
WA
Other
Enumeration date
05/26/2017
Last updated
07/21/2022
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