Provider Demographics
NPI:1952921124
Name:EMPRES AT SEATTLE, LLC
Entity Type:Organization
Organization Name:EMPRES AT SEATTLE, LLC
Other - Org Name:TRANSITIONAL CARE CENTER OF SEATTLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-892-6628
Mailing Address - Street 1:4601 NE 77TH AVE # SUIE300
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6729
Mailing Address - Country:US
Mailing Address - Phone:360-892-6628
Mailing Address - Fax:360-882-5789
Practice Address - Street 1:2611 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-3013
Practice Address - Country:US
Practice Address - Phone:360-892-6628
Practice Address - Fax:360-882-5793
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPRES WASHINGTON HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-17
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA505534OtherMEDICARE
WA2155326Medicaid
WA604595856OtherSECRETARY OF STATE
WA1621OtherDSHS NH LICENSE
WA50D2192671OtherCLIA WAIVER