PACIFICA KENMORE LLC (NPI# 1275131237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275131237 |
| Entity Type | Organization |
| Organization Name | PACIFICA KENMORE LLC |
| Practice Address |
7221 Ne 182nd Street Kenmore WA 98028 |
| Mailing Address |
1775 Hancock Street Suite 200 San Diego CA 92110 |
| Practice Telephone | 4254814200 |
| Mailing Telephone | 6192969000 |
| Mailing Fax Number | 6192969090 |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | DEEPAK ISRANI (GENERAL MANAGER) |
| Authorized Official Telephone | 6192969000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Kenmore Senior Living | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFICA KENMORE LLC | 1775 Hancock St Ste 200, San Diego, CA 92110-2036 |
| Street Address |
7221 NE 182ND STREET |
| City | KENMORE |
| State | WA |
| Zip Code | 98028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173183 | Reiko Margarete Kobayashi-wagner | Dietitian, Registered | 17512 83rd Pl Ne, C304, Kenmore, WA 98028 | 2017-09-13 |
| 1356866776 | Matthew Vaughn | Specialist/Technologist | 6741 Ne 182nd St, Unit C313, Kenmore, WA 98028 | 2017-08-07 |
| 1619407467 | Suzanne Marie Gisch | Family Medicine | 18151 68th Ave Ne, Unit 219, Kenmore, WA 98028 | 2017-06-14 |
| 1063853018 | Vinai Prakash | Podiatrist | 6610 Ne 181st St Ste 4, Kenmore, WA 98028 | 2013-07-07 |
| 1760732580 | Benjamin Dorantes Dds Pllc | Dentist | 5710 Bothell Way Ne, Ste. 5, Kenmore, WA 98028 | 2012-09-19 |
| 1538491378 | Kellie A Cheever | Massage Therapist | 8846 Ne 160th Pl, Kenmore, WA 98028 | 2010-02-04 |
| 1275867855 | Mei-hsuan Ko | Dentist | 5723 Ne Bothell Way Ste C, Kenmore, WA 98028 | 2009-09-29 |
| 1659521912 | Wayne E Carr | Psychologist | 7800 N E Bothell Way, Suite 155 B, Kenmore, WA 98028 | 2008-09-23 |
| 1366625899 | Kevin Michael Smith | Chiropractor | 7249 Ne 171st Ln, Kenmore, WA 98028 | 2007-12-06 |
| 1760535827 | Victoria A Rotton | Counselor | 15004 70th Ave Ne, Kenmore, WA 98028 | 2007-01-19 |
| Find all providers in zip 98028 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619195229 | Kenmore Senior Living LLC | Assisted Living Facility | 7221 Ne 182nd St, Kenmore, WA 98028-2797 | 2007-04-22 |
| 1053625285 | Emeritus Corporation | Assisted Living Facility | 7221 Ne 182nd St, Kenmore, WA 98028-2797 | 2010-07-29 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.