- Enrollment id
- O20250328000246
- Enrollment state
- WA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1174345193
- Multiple npi flag
- N
- Ccn
- 501515
- Associate id
- 0042733222
- Organization name
- CP SEATTLE WA HOSPICE LLC
- Doing business as name
- PROVIDENCE AT HOME WITH COMPASSUS HOSPICE CARE, PUGET SOUND
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2811 S 102ND ST
- Address line 2
- STE 220
- City
- TUKWILA
- State
- WA
- Zip code
- 981681869