Provider Demographics
NPI:1124474176
Name:KIN ON COMMUNITY HEALTH CARE
Entity type:Organization
Organization Name:KIN ON COMMUNITY HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-652-2330
Mailing Address - Street 1:815 S WELLER ST
Mailing Address - Street 2:STE 212
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3024
Mailing Address - Country:US
Mailing Address - Phone:206-652-2330
Mailing Address - Fax:
Practice Address - Street 1:815 S WELLER ST
Practice Address - Street 2:STE 212
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3024
Practice Address - Country:US
Practice Address - Phone:206-652-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.00000358253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care