Luna Vega Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LUNA VEGA HEALTHCARE LLC

Doing business as

Marianwood Health and Rehabilition

Practice address

3725 Providence Point Dr SE
Issaquah, WA 98029-7219

Phone

(425) 391-2800

NPI assigned

Sep 16, 2024

Last updated

Feb 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Secretary

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other names 1

• Marianwood Health and Rehabilition Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194552919. Details of each certification follow.

• CCN 505418 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 505418

Legal name

LUNA VEGA HEALTHCARE LLC

Doing business as

MARIANWOOD HEALTH AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1992

Last certification

Aug 1, 2024

Beds

117

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

3725 Providence Point Dr SE
Issaquah, WA 98029-7219

Nursing home name

MARIANWOOD HEALTH AND REHABILITATION

Affiliated entity

THE ENSIGN GROUP

Listed as

Marianwood Health and RehabilitationCCN 505418 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11782.2 residents per day on average

Chain

The Ensign Group342 facilities in the chain

Penalties (3 years)

2Fines totaling $64,574

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

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

• Lisa Marie Stolarczyk, M.D.

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1497930176

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Lisa Marie Stolarczyk, M.D.

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1497930176
  NPD (past)

Affiliated clinicians 3

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

• Neeta Bhogal, MD

  • Family Medicine Physician
  • Everett, WA
  • NPI 1154473833

  Nursing home

  Care Compare affiliation
• Lucas Marian Kogut, MD

  • Family Medicine Physician
  • Bremerton, WA
  • NPI 1225753684

  Nursing home

  Care Compare affiliation
• Maggie Sekeramayi, MD

  • Internal Medicine Physician
  • Lakewood, WA
  • NPI 1801099791

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1194552919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 PROVIDENCE POINT DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297219",
            "telephone_number": "425-391-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 PROVIDENCE POINT DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297219",
            "telephone_number": "425-391-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA VEGA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marianwood Health and Rehabilition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Audrey J Lowenthal, ARNP
• Kimberly Lu, M.D.
• Norma Adrienne Lubeck, D.O.
• Kristy Ann Ludwig, PH.D.
• Luis Vega, DDS, PLLC
• Rose Jael Luncasu-Rolea, OTR
• Fei Luo, PH.D., CCC-SLP
• Hsuan-Chieh Jasper Luoh, DO
• Megan Elizabeth Lupa, PA-C
• Michelle Lutz, DPT, OCS

• Skilled Nursing Facility in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.