Provider Demographics
NPI:1366441834
Name:KIN ON HEALTH CARE CENTER
Entity Type:Organization
Organization Name:KIN ON HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-556-2222
Mailing Address - Street 1:4416 S BRANDON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2341
Mailing Address - Country:US
Mailing Address - Phone:206-721-3630
Mailing Address - Fax:206-721-3626
Practice Address - Street 1:4416 S BRANDON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2341
Practice Address - Country:US
Practice Address - Phone:206-721-3630
Practice Address - Fax:206-721-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1221314000000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4112215Medicaid
WA505453AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WA4112215Medicaid