Organization
CRYSTAL HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY LEE (PRESIDENT)
(425) 606-7049
Entity
Organization
Contact information
Practice address
1301 67TH ST SE UNIT 16B, AUBURN, WA 98092-8167
(425) 606-7049
(253) 322-0611
Mailing address
1301 67 CT SE, #16B, AUBURN, WA 98092
(425) 606-7049
(253) 322-0611
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
IHS.FS.60727004
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHS.FS.60727004
SERVICES AGENCY LICENSE
WA
Enumeration date
08/21/2017
Last updated
07/21/2022
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