Provider Demographics
NPI:1043870413
Name:HEALTHY LIVING AT HOME - SEATTLE, LLC
Entity type:Organization
Organization Name:HEALTHY LIVING AT HOME - SEATTLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHACKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-495-5474
Mailing Address - Street 1:1499 SE TECH CENTER PL STE 140
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9575
Mailing Address - Country:US
Mailing Address - Phone:360-859-4886
Mailing Address - Fax:360-859-4891
Practice Address - Street 1:801 2ND AVE STE 800
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1573
Practice Address - Country:US
Practice Address - Phone:480-495-5474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health