Manor Care of Lynnwood Wa, Association

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

956 Issued in WA

Legal business name

MANOR CARE OF LYNNWOOD WA, ASSOCIATION

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Lynnwood)

Practice address

3701 188TH St SW
Lynnwood, WA 98037-7626

Phone

(425) 775-9222

Fax

(425) 712-3685

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Lynnwood) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1235174517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 188TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980377626",
            "telephone_number": "425-775-9222",
            "fax_number": "425-712-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF LYNNWOOD WA, ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114096",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Lynnwood)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chitra Manickam, MD
• Michelle Manire
• Hadiya Manners
• Kristin Ann Manning, M.D.
• Mary E Manning, RPH
• Maraki Nursing Care Services (Trusted Hands Private Duty Nurse)
• Olivia Grace Marbet
• Harrison Patrick March, MD
• Molly Marchion
• Kristie Jo Marlett, PHARM D

• Skilled Nursing Facility in Lynnwood, WA
• Providers in Lynnwood, 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 11, 2022; 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.