NPI 1588043020

Independence Rehab LLC

Organisation Skilled Nursing Facility Bellevue, WA

Practice location

Address: 919 109th Ave NE, Bellevue, WA 98004-4485
Phone: (425) 233-8766
Mailing address: 12123 NE 172nd Pl M201, Bothell, WA 98011-6409

Authorised official

Name: Chad Fullmer
Title: Senior Vice President
Phone: (801) 426-4905

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence LL60391131 (WA)

Other Skilled Nursing Facility providers in Washington →

Registry record

NPI: 1588043020
Entity type: Organization
NPI issued: 28 May 2015
Record last updated: 28 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.