Organization
TOTAL RENAL CARE INC
Active
Other names
Mill Creek Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
18001 BOTHELL EVERETT HWY STE 112, BOTHELL, WA 98012-1661
(425) 481-5258
(425) 481-3438
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790928802
—
WA
Enumeration date
04/20/2009
Last updated
04/25/2024
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