Sherwood Adult Family Home, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

751565 Issued in WA

Legal business name

SHERWOOD ADULT FAMILY HOME, LLC

Practice address

11017 NE Sherwood Drive
Vancouver, WA 98686

Phone

(360) 718-8543

Fax

(360) 718-8645

NPI assigned

Mar 26, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Laurie M Davis, RN00069341

Title

Owner, Operator

Phone

(360) 718-8543

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1255607198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11017 NE SHERWOOD DRIVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-718-8543",
            "fax_number": "360-718-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11017 NE SHERWOOD DRIVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-718-8543",
            "fax_number": "360-718-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERWOOD ADULT FAMILY HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, OPERATOR",
        "authorized_official_telephone_number": "360-718-8543",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN00069341"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "WA",
            "license": "751565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Richard Sheron, DDS
• Richard Sheron, DMD
• Dadiki Sherpa, PA
• Jocelynn Elyssa Sherrill
• Jillian E. Sherrodd Wing, SLP
• Kymberli Sherwood, LMHC, ATR
• Megan Sherwood
• Angela Shevchenko
• Timofey Shevchenko, RN
• Junzi Shi, MD

• Custodial Care Facility in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Custodial Care Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.