Provider Demographics
NPI:1841762382
Name:WELLTOWER COGIR TENANT LLC
Entity Type:Organization
Organization Name:WELLTOWER COGIR TENANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENOIT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:418-209-6169
Mailing Address - Street 1:14905 BOTHELL EVERETT HWY
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5315
Mailing Address - Country:US
Mailing Address - Phone:418-209-6169
Mailing Address - Fax:
Practice Address - Street 1:11501 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6320
Practice Address - Country:US
Practice Address - Phone:206-362-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization