Organization
STAFFORD HEALTHCARE, SEATAC, LLC
Active
Other names
Stafford Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES KENNETH BENNETT JR. MHA (VICE PRESIDENT OF OPERATIONS)
(206) 824-0600
Entity
Organization
Contact information
Practice address
2800 SOUTH 224TH ST, DES MOINES, WA 98198-5132
(206) 824-0600
(206) 824-5622
Mailing address
2800 SOUTH 224TH ST, DES MOINES, WA 96198-5132
(206) 824-0600
(206) 824-5622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1364
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113613
—
WA
05
—
4113643
—
WA
Enumeration date
11/04/2005
Last updated
12/08/2009
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