Organization
FRED LIND MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK MULLEN (EXECUTIVE DIRECTOR)
(206) 324-1632
Entity
Organization
Contact information
Practice address
1802 17TH AVE, SEATTLE, WA 98122-2722
(206) 324-1632
(206) 323-0485
Mailing address
1802 17TH AVE, SEATTLE, WA 98122-2722
(206) 324-1632
(206) 323-0485
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
864
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114803
—
WA
Enumeration date
03/17/2014
Last updated
03/17/2014
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