Organization
BD TACOMA I, LLC
Active
Other names
PARK ROSE CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DEVORE (FIELD ACCOUNTANT)
(425) 392-4066
Entity
Organization
Contact information
Practice address
3919 S 19TH ST, TACOMA, WA 98405-1414
(253) 752-5677
(253) 756-8936
Mailing address
3326 160TH AVE SE, SUITE 120, BELLEVUE, WA 98008-6418
(425) 392-4066
(425) 623-1517
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1298
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112983
—
WA
05
—
4114245
—
WA
Enumeration date
09/20/2006
Last updated
05/15/2015
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