Fmg 72nd Avenue West Washington LLC
NPI #1932507225 in Edmonds, Washington
Provider Information
- NPI Number
- 1932507225
- Entity Type
- Organization
- Organization Name
- Fmg 72nd Avenue West Washington LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 18, 2014
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 21400 72ND AVE W
- City
- Edmonds
- State
- Washington
- ZIP Code
- 98026-7702
- Phone
- (425) 775-1961
Authorized Official
- Name
- DAVID C. KEATING
- Title
- AGENT
- Phone
- (414) 908-8058
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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