Life Care at Home of Washington, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

IS364 Issued in WA

Legal business name

LIFE CARE AT HOME OF WASHINGTON, INC

Practice address

505 Cedar Ave
B-1
Marysville, WA 98270-4561

Phone

(360) 659-1487

Fax

(360) 659-0726

NPI assigned

Jun 23, 2005

Organization subpart

No

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

Authorized official

Name

Pam Rau

Title

VP of Finanace

Phone

(423) 473-5280

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1063418093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "address_2": "P O BOX 3480",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5256",
            "fax_number": "423-339-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CEDAR AVE",
            "address_2": "B-1",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704561",
            "telephone_number": "360-659-1487",
            "fax_number": "360-659-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE AT HOME OF WASHINGTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "RAU",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "VP OF FINANACE",
        "authorized_official_telephone_number": "423-473-5280"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "1116",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9044900",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kate Li, PHARMD
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• Alisha Lim
• Taylor Lindbloom
• Deja Link, PA-C

• Home Health Agency in Marysville, WA
• Providers in Marysville, WA by specialty
• Home Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.