Provider Demographics
NPI:1346678851
Name:CAROLINE KLINE GALLAND HOME
Entity Type:Organization
Organization Name:CAROLINE KLINE GALLAND HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-725-8800
Mailing Address - Street 1:7500 SEWARD PARK AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4247
Mailing Address - Country:US
Mailing Address - Phone:206-725-8800
Mailing Address - Fax:206-722-5210
Practice Address - Street 1:5950 6TH AVE S
Practice Address - Street 2:STE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-3317
Practice Address - Country:US
Practice Address - Phone:206-805-1930
Practice Address - Fax:206-805-1931
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINE KLINE GALLAND HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-18
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.60103742251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8928174Medicare Oscar/Certification