Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Ballard Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 821-3355
Entity
Organization
Contact information
Practice address
820 NW 95TH ST, SEATTLE, WA 98117-2207
(206) 782-0100
(206) 781-1448
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1337
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4114419
—
WA
01
—
7080WH
REGENCE BLUE SHIELD
WA
Enumeration date
05/26/2006
Last updated
07/13/2015
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