| Organization Name: | PAIGE SUSAN LLC |
| NPI Number: | 1417267345 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND FITZGIBBON (GENERAL MANAGER) |
| Mailing Address: | 5501 4th Ave S Suite 203 Seattle |
| State: | WA US |
| Postal Code: | 981082447 |
| Phone Number: | 2064204934 |
| Fax Number: | 2062570372 |
| NPI Enumeration Date: | 10/13/2010 |
| NPI Last Update Date: | 10/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | IHS.FS.60151137 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |