Provider Demographics
NPI:1578632568
Name:THC - SEATTLE, LLC
Entity Type:Organization
Organization Name:THC - SEATTLE, LLC
Other - Org Name:KINDRED HOSPITAL SEATTLE - NORTHGATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:10631 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7213
Mailing Address - Country:US
Mailing Address - Phone:206-364-2050
Mailing Address - Fax:206-361-5722
Practice Address - Street 1:10631 8TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-364-2050
Practice Address - Fax:206-361-5722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-148282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3200318Medicaid
WA60OtherBLUE CROSS
WA=========OtherHUMANA
WA60OtherBLUE CROSS
WA=========OtherAETNA
WA=========OtherCIGNA
WA=========OtherUNITED HEALTHCARE
WA3200318Medicaid
WA=========OtherHUMANA