NPIMap

Organization Active NPI

Multicare Health System

Doing business as MultiCare Good Samaritan Hospital

  • Rehabilitation Hospital Unit
  • Puyallup, WA
National Provider Identifier
1083655625
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
H-081 Issued in WA
Legal business name
MULTICARE HEALTH SYSTEM
Doing business as
MultiCare Good Samaritan Hospital
Practice address
407 14TH Ave SE
Puyallup, WA 98372-3770
Phone
(253) 697-2065
NPI assigned
Jun 8, 2006
Last updated
Aug 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
William Glenn Robertson
Title
Ceo
Phone
(253) 403-1272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X H-081 WA Primary

Addresses

Primary practice location

407 14TH Ave SE
Puyallup, WA 98372-3770

Mailing address

P.O. Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other identifiers 1

IdentifierTypeStateIssuer
2012153MedicaidWA

Other names 1

  • MultiCare Good Samaritan Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110516000666 WA Part A Provider - Hospital 7719899897 Practice locations: Puyallup, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083655625. Details of each certification follow.

Hospital certification: CCN 50T079

Legal name
MULTICARE HEALTH SYSTEM
Doing business as
MULTICARE GOOD SAMARITAN HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1986 in WA
Enrollment address
401 15TH Ave SE
Puyallup, WA 98372-3715
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Multicare Good Samaritan HospitalCCN 50T079 · All quality measures
Ownership
Non-profit
Certified
Aug 1, 2016

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
William G Robertson Individual Corporate OfficerCeo Apr 1, 2014
W-2 Managing EmployeeCeo Apr 1, 2014
Leslie Dale Sowell Individual Corporate Director Apr 1, 2011
Robert Yost Individual Corporate Director Apr 1, 2011
John Wiborg Individual Corporate Director Apr 1, 2011
Tariq Salam Individual W-2 Managing Employee Nov 1, 2020
James Gyeong-Jin Lee Individual Corporate OfficerEvp and Cfo Jun 1, 2022
W-2 Managing EmployeeEvp and Cfo Jun 1, 2022
Tara Perry Individual Corporate Director Aug 25, 2021
Florence Chang Individual Corporate Officer Jan 1, 2015
W-2 Managing Employee Jan 1, 2015
Robin J Thomashauer Individual Corporate Director Nov 1, 2020
Janine Terrano Individual Corporate Director Apr 1, 2014
Frank Tombari Individual Corporate Director Jan 28, 2022
Deedee Walkey Individual Corporate Director Apr 1, 2011
Sally Leighton Individual Corporate Director Apr 1, 2011
Multicare Health System Organization, Tacoma, WA Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2011
John Folsom Individual Corporate Director Apr 1, 2011
Joanna Monroe Individual Corporate Director Jan 1, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 22

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tacoma General/Allenmore HospitalTacoma, WA, CCN 500129 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 1986
Mary Bridge Children's HospitalTacoma, WA, CCN 503301 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990
West Seattle Psychiatric HospitalSeattle, WA, CCN 504009 Hospital 5% Or Greater Indirect Ownership Interest (100%) May 1, 2017
Overlake Medical Center & ClinicsBellevue, WA, CCN 500051 Hospital Operational/Managerial Control (100%) Oct 1, 2024
Overlake Medical Center & ClinicsBellevue, WA, CCN 50S051 Hospital Operational/Managerial Control (100%) Oct 1, 2024
Yakima Valley MemorialYakima, WA, CCN 500036 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 17, 2023
Multicare Good Samaritan HospitalPuyallup, WA, CCN 500079 Hospital 5% Or Greater Direct Ownership Interest (100%) May 16, 2011
Yakima Valley Memorial Hospital AssociationYakima, WA, CCN 50S036 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 17, 2023
Multicare Auburn Medical CenterAuburn, WA, CCN 500015 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2012
Multicare Behavioral Health Inpatient Services-AuburnAuburn, WA, CCN 50S015 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2012
Multicare Valley HospitalSpokane Valley, WA, CCN 500119 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 30, 2017
Multicare Deaconess HospitalSpokane, WA, CCN 500044 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017
Multicare Covington Medical CenterCovington, WA, CCN 500154 Hospital 5% Or Greater Direct Ownership Interest Feb 18, 2018
Wellfound Behavioral Health HospitalTacoma, WA, CCN 504016 Hospital 5% Or Greater Direct Ownership Interest (50%) Feb 1, 2016
Multicare Capital Medical CenterOlympia, WA, CCN 500139 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 5, 2021
Garden VillageYakima, WA, CCN 505010 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jul 1, 2010
Avalon Healthcare - TacomaTacoma, WA, CCN 505183 Skilled nursing facility Adp of the SNF
Direct Ownership Interest (50%)		 Aug 1, 2024
Aug 1, 2024
Multicare Home HealthTacoma, WA, CCN 507046 Home health agency 5% Or Greater Direct Ownership Interest Sep 21, 2007
Memorial Home Care ServicesYakima, WA, CCN 507028 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jan 17, 2023
Memorial Home Care / Hospice ServicesYakima, WA, CCN 501531 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 17, 2023
Multicare HospiceTacoma, WA, CCN 501508 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2011
Apr 1, 2011
PNW Hospice LLCTacoma, WA, CCN 501555 Hospice 5% Or Greater Direct Ownership Interest (100%) May 3, 2023

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1083655625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723770",
            "telephone_number": "253-697-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTICARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-403-1272"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "WA",
            "license": "H-081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012153",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MultiCare Good Samaritan Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.