Organization
BROADVIEW DEVELOPMENT ASSOCIATES II
Active
Other names
Ida Culver House Broadview Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L TRAVERS NHA (DIRECTOR OF CLINICAL SERVICES ADMIN)
(206) 368-3797
Entity
Organization
Contact information
Practice address
12505 GREENWOOD AVE N, SEATTLE, WA 98133
(206) 368-3797
(206) 368-3756
Mailing address
12505 GREENWOOD AVE N, SEATTLE, WA 98133
(206) 368-3797
(206) 368-3756
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
945
WA
314000000X
Skilled Nursing Facility
Primary
1065
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4110656
—
WA
01
—
CU2614
REGENCE BLUE SHIELD
—
Enumeration date
04/28/2006
Last updated
05/28/2015
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