Mary Adult Family Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

656400 Issued in WA

Legal business name

MARY ADULT FAMILY HOME

Practice address

1438 Dogwood St SE
Auburn, WA 98092-6476

Phone

(253) 876-7726

Fax

(253) 876-0063

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Dragomir, NAR

Title

Provider

Phone

(253) 876-7726

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1184895906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 DOGWOOD ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980926476",
            "telephone_number": "253-876-7726",
            "fax_number": "253-876-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 DOGWOOD ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980926476",
            "telephone_number": "253-876-7726",
            "fax_number": "253-876-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ADULT FAMILY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "DRAGOMIR",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "253-876-7726",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NAR"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "656400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098774",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amelia Martinez Martinez
• Consuelo Martinez Ortega Jr., MEDICAL INTERPRETER
• Gabriana Martinez-Garcia
• Luz M Martinez, NC60044435
• Sarah Martinez
• Dixie Masnov, RC
• Merajuddin Masood
• Mateas Corporation
• Paul Mathenge, PMHNP-BC
• Meredith S Matheson, ICCE, ICBD

• Adult Care Home Facility in Auburn, WA
• Providers in Auburn, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.