Provider Demographics
NPI:1942546239
Name:AMEDISYS WASHINGTON, LLC
Entity Type:Organization
Organization Name:AMEDISYS WASHINGTON, LLC
Other - Org Name:AMEDISYS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:1800 136TH PLACE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2343
Mailing Address - Country:US
Mailing Address - Phone:425-800-5557
Mailing Address - Fax:615-221-2280
Practice Address - Street 1:1800 136TH PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2343
Practice Address - Country:US
Practice Address - Phone:425-800-5557
Practice Address - Fax:253-838-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
50-7123OtherCMS CERTIFICATION NUMBER