Provider Demographics
NPI:1710907233
Name:KINDRED NURSING CENTERS WEST, LLC
Entity Type:Organization
Organization Name:KINDRED NURSING CENTERS WEST, LLC
Other - Org Name:KINDRED NURSING AND REHABILITATION-ARDEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7563
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:502-596-7301
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:16357 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-5651
Practice Address - Country:US
Practice Address - Phone:206-542-3103
Practice Address - Fax:206-542-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1284314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA505214OtherGROUP HEALTH
WA505214OtherUNIFORM MEDICAL
WA505214OtherPREMERA BLUE CROSS
WA4112843Medicaid
WA505214OtherAETNA
WA505214OtherFIRST CHOICE
WA505214OtherREGENCE
WA505214OtherUNITED HEALTHCARE
WA505214OtherSECURE HORIZONS
WA505214Medicare Oscar/Certification