Mission Healthcare at Renton, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MISSION HEALTHCARE AT RENTON, LLC

Doing business as

Mission Healthcare at Renton

Practice address

17420 106TH PL SE
Renton, WA 98055-5438

Phone

(425) 897-8800

Fax

(425) 897-8801

NPI assigned

May 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth Farmer, MD

Title

Chief Executive Officer

Phone

(253) 853-4457

Specialties & licenses 1

Addresses

Other names 1

• Mission Healthcare at Renton Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1457840795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17420 106TH PL SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555438",
            "telephone_number": "425-897-8800",
            "fax_number": "425-897-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17420 106TH PL SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555438",
            "telephone_number": "425-897-8800",
            "fax_number": "425-897-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HEALTHCARE AT RENTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "253-853-4457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Healthcare at Renton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Minuteclinic Primary Care Washington PLLC
• Wendy Mironov, ARNP
• Krisha-Tyra Misa, DDS, MS
• Michael Aziz Mishalanie, DPM
• Mission Healthcare at Bellevue, Joint Venture (Mission Healthcare at Renton)
• Leanne Mitchell, PT
• Myesha Mitchell
• Taryn Reiko Miyaoka, PA-C
• Hikari Daniel Mizukami, DPT
• Rachel Mlanao, MD

• Skilled Nursing Facility in Renton, WA
• Providers in Renton, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.