Sunbridge Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1337 Issued in WA

Legal business name

SUNBRIDGE HEALTHCARE LLC

Doing business as

Ballard Center

Practice address

820 NW 95TH St
Seattle, WA 98117-2207

Phone

(206) 782-0100

Fax

(206) 781-1448

NPI assigned

May 26, 2006

Last updated

Jul 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Berg

Title

Assistant Secretary

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ballard Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sunbridge Healthcare LLC

  dba Columbia Crest Center

  • Skilled Nursing Facility
  • Moses Lake, WA
  • NPI 1982651758

  Member Of

  NPD member

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1710933999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NW 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172207",
            "telephone_number": "206-782-0100",
            "fax_number": "206-781-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "7080WH",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114419",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballard Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samuel S. Sun, DDS
• Wensi Sun, M.D., PH.D.
• Yuxin Sun
• Yuxuan Sun
• Kailey Sunagel
• Sunburst Psychology, PLLC
• Miel Sundararajan, M.D.
• Erin Sundberg
• Randi Marit Sundby, MSPT
• Ian Richard Sunderland, MD

• Skilled Nursing Facility in Seattle, WA
• Providers in Seattle, 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 Jul 13, 2015; 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.