Provider Demographics
NPI:1538330832
Name:VALLEY VIEW SENIOR CARE
Entity Type:Organization
Organization Name:VALLEY VIEW SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:POTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-850-8439
Mailing Address - Street 1:615 SUMMIT AVE N
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-4707
Mailing Address - Country:US
Mailing Address - Phone:263-850-8439
Mailing Address - Fax:253-373-1399
Practice Address - Street 1:615 SUMMIT AVE N
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-4707
Practice Address - Country:US
Practice Address - Phone:263-850-8439
Practice Address - Fax:253-373-1399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA695200311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home